Adolescent Inhalant Use Associated With Higher Risk for Psychosis

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Inhalant and other substance use during adolescence are increasingly associated with many adverse health and psychosocial outcomes.

Inhalant use in adolescence increases the risk for psychosis, according to research published in Schizophrenia Research. Researchers also identified a dose-response effect between inhalant use and risk for psychosis.

In this first longitudinal study assessing the association between inhalant use and risk for psychosis, researchers examined 225 participants with inhalant use from the Northern Finland Birth Cohort 1986. At 15 to 16 years old, participants were given self-report questionnaires on substance use and psychotic experiences. Inhalant use was categorized into 4 groups (never, once, 2-4 times, 5 or more times), and subsequent psychosis diagnoses were obtained from national registers until age 30 years.

The use of self-reports, as well as the higher rate of nonparticipation of participants from nonintact families in urban areas, presents limitations to the study. In addition, data were not collected on age of first use, exposure to childhood trauma, or abuse and neglect.

Of the 225 participants with inhalant use, 18 were diagnosed with psychosis, indicating an increased risk for incident psychosis compared with the risk for nonusers. The increased risk persisted even after adjusting for baseline psychotic experience, other substance use, comorbid mental disorders, and parental substance abuse. Adolescents with frequent alcohol use, cannabis use, daily smoking, and other substance use, as well as subjects with a history of parental substance abuse use, were more likely to be inhalant users and had a higher incidence rate of psychosis during follow-up. Participants from nonintact families were also more likely to use inhalants, although this covariate was not associated with a diagnosis of psychosis.

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“The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents,” the researchers noted.

These findings require further examination through additional longitudinal studies examining the role of inhalant use in pathogenesis psychosis. Inhalant and other substance use during adolescence are increasingly associated with many adverse health and psychosocial outcomes. Researchers urge that “implementation of effective policies to reduce rates of substance use in adolescents are needed to improve the future health of young people.”


Mustonen A, Niemelä S, BcGrath JJ, et al. Adolescent inhalant use and psychosis risk – a prospective longitudinal study [published online June 26, 2018]. Schizophr Res. doi: 10.1016/j.schres.2018.05.013