Substance use and psychotic-like experiences in young people: A systematic review and meta-analysis

Journal article

Matheson, S. L., Laurie, Mallory and Laurens, Kristin. (2023). Substance use and psychotic-like experiences in young people: A systematic review and meta-analysis. Psychological Medicine. 53(2), pp. 305-319.
AuthorsMatheson, S. L., Laurie, Mallory and Laurens, Kristin

This study aimed to systematically review and synthesise the available evidence on the prevalence and associations between psychotic-like experiences (PLEs) and substance use in children and adolescents aged ⩽17 years, prior to the typical age of development of prodromal symptoms of psychosis. As substance use has been associated with earlier age of psychosis onset and more severe illness, identifying risk processes in the premorbid phase of the illness may offer opportunities to prevent the development of prodromal symptoms and psychotic illness. MEDLINE, PsycINFO, and CINAHL databases were searched for chart review, case-control, cohort, twin, and cross-sectional studies. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, and pooled evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Searches identified 55 studies that met inclusion criteria. Around two-in-five substance users reported PLEs [rate = 0.41, 95% confidence interval (CI) 0.32–0.51; low quality evidence], and one-in-five with PLEs reported using substances (rate = 0.19, 95% CI 0.12–0.28; moderate-to-high quality evidence). Substance users were nearly twice as likely to report PLEs than non-users [odds ratio (OR) 1.77, 95% CI 1.55–2.02; moderate quality evidence], and those with PLEs were twice as likely to use substances than those not reporting PLEs (OR 1.93, 95% CI 1.55–2.41; very low quality evidence). Younger age was associated with greater odds of PLEs in substance users compared to non-users. Young substance users may represent a subclinical at-risk group for psychosis. Developing early detection and intervention for both substance use and PLEs may reduce long-term adverse outcomes.

JournalPsychological Medicine
Journal citation53 (2), pp. 305-319
PublisherCambridge University Press
Digital Object Identifier (DOI)
PubMed ID36377500
Scopus EID2-s2.0-85147821069
PubMed Central IDPMC9899577
Open accessPublished as ‘gold’ (paid) open access
Page range305-319
FunderAustralian Research Council (ARC)
Publisher's version
File Access Level
Output statusPublished
Publication dates
Online15 Nov 2022
Publication process dates
Deposited02 Jun 2023
ARC Funded ResearchThis output has been funded, wholly or partially, under the Australian Research Council Act 2001
Grant IDFT170100294
Permalink -

Download files

Publisher's version
  • 34
    total views
  • 36
    total downloads
  • 2
    views this month
  • 4
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as