Cannabis was the most commonly used substance among first-episode psychosis patients at a South African hospital
In a review of 200 first-episode psychosis patients at a Soweto hospital, 73.6% had used substances, with cannabis being the most common at 46%, and substance-induced psychotic disorder was the most frequent diagnosis.
Quick Facts
What This Study Found
Substance use prevalence among first-episode psychosis patients was 73.6%. Cannabis was the most commonly used substance (46%). Substance-induced psychotic disorder was the most common diagnosis, and substance use was associated with aggression in 45% of cases.
Key Numbers
200 patients reviewed. 73.6% prevalence of substance use. Cannabis most common at 46%. Most patients were male, aged 21-30 (37%). Aggression associated with substance use in 45% of cases. Only 34% of substance users were referred to social services.
How They Did This
Retrospective chart review of 200 patients presenting with first-episode psychosis at Chris Hani Baragwanath Academic Hospital, a tertiary facility in Soweto, South Africa. Clinical records were analyzed and patients with and without substance use were compared statistically.
Why This Research Matters
South Africa has limited mental health resources and high rates of substance use. Understanding the overlap between substance use and first-episode psychosis in this population can inform targeted prevention and integrated treatment strategies.
The Bigger Picture
This study adds to the global evidence on cannabis-psychosis associations from an understudied population in sub-Saharan Africa, where substance use patterns and available healthcare resources differ substantially from high-income countries.
What This Study Doesn't Tell Us
Retrospective chart review limits data quality and completeness. Single hospital setting in Soweto may not generalize to other South African populations. Cannot establish causal direction between substance use and psychosis.
Questions This Raises
- ?Why were only 34% of substance users referred to social services?
- ?How do outcomes differ when integrated mental health and substance use treatment is provided in this setting?
Trust & Context
- Key Stat:
- 73.6% of first-episode psychosis patients used substances; cannabis most common at 46%
- Evidence Grade:
- Moderate: retrospective chart review at a single tertiary hospital with a reasonable sample size but inherent limitations of chart-based data.
- Study Age:
- Published 2026.
- Original Title:
- Substance abuse in first-episode psychosis at Chris Hani Baragwanath Hospital.
- Published In:
- The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 32, 2542 (2026)
- Authors:
- Shandu, Precious N, Minty, Yumna
- Database ID:
- RTHC-08616
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
How common is substance use among people with first-episode psychosis in South Africa?
This study found 73.6% of first-episode psychosis patients at a Soweto hospital had used substances, with cannabis being the most common at 46%.
What was the most common diagnosis among substance-using psychosis patients?
Substance-induced psychotic disorder was the most common diagnosis in this population.
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Cite This Study
https://rethinkthc.com/research/RTHC-08616APA
Shandu, Precious N; Minty, Yumna. (2026). Substance abuse in first-episode psychosis at Chris Hani Baragwanath Hospital.. The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 32, 2542. https://doi.org/10.4102/sajpsychiatry.v32i0.2542
MLA
Shandu, Precious N, et al. "Substance abuse in first-episode psychosis at Chris Hani Baragwanath Hospital.." The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 2026. https://doi.org/10.4102/sajpsychiatry.v32i0.2542
RethinkTHC
RethinkTHC Research Database. "Substance abuse in first-episode psychosis at Chris Hani Bar..." RTHC-08616. Retrieved from https://rethinkthc.com/research/shandu-2026-substance-abuse-in-firstepisode
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.