{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:22:09Z","timestamp":1792758129031,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T00:00:00Z","timestamp":1501027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Longitudinal research into early intervention for youth at ultra high risk (<jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content>) for psychosis demonstrates beneficial outcomes including increased treatment compliance and greater participation in education and the workforce. Despite known barriers for rural youth accessing mental health services, research comparing urban and rural <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> youth is lacking. The study included an examination of the impact of substance use on functioning of <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> youth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Youth aged 12 to 25 years were recruited from the urban area of Newcastle or the rural area of Orange, New South Wales, Australia, and identified as <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> by the Comprehensive Assessment of At Risk Mental States. Rural and urban youth were compared on clinical profiles, social and occupational functioning and substance use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rural youth showed different help\u2010seeking behaviours and had greater functional impairment than urban youth. Substance use was common across the sample of 57 youth (mean age 16.5\u2009years, 56% female) and a history of hazardous substance use was associated with higher levels of depression. Rural youth (n\u2009=\u200932) were more likely than urban youth to be taking antidepressants at baseline (44% compared with 16%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Different patterns of help seeking by rural <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> youth suggest a need for greater access to psychosis informed primary care early intervention services. Interventions should target functional decline to prevent adverse outcomes such as reduced community participation and unemployment. In addition, interventions for substance use should be a priority for <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> youth, who should also be screened and monitored for depressive symptoms and treated for depression if indicated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eip.12437","type":"journal-article","created":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T08:04:37Z","timestamp":1501056277000},"page":"1173-1180","source":"Crossref","is-referenced-by-count":10,"title":["Impact of rurality and substance use on young people at ultra high risk for psychosis"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-4780","authenticated-orcid":false,"given":"Helen J.","family":"Stain","sequence":"first","affiliation":[{"name":"School of Medicine, Pharmacy and Health Durham University  Durham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean A.","family":"Halpin","sequence":"additional","affiliation":[{"name":"School of Psychology University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda L.","family":"Baker","sequence":"additional","affiliation":[{"name":"Priority Research Centre for Translational Neuroscience and Mental Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Hunter Medical Research Institute  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Startup","sequence":"additional","affiliation":[{"name":"School of Psychology University of Newcastle  Newcastle New South Wales Australia"},{"name":"Priority Research Centre for Translational Neuroscience and Mental Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Hunter Medical Research Institute  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaughan J.","family":"Carr","sequence":"additional","affiliation":[{"name":"Schizophrenia Research Institute  Sydney New South Wales Australia"},{"name":"School of Psychiatry University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Schall","sequence":"additional","affiliation":[{"name":"Priority Research Centre for Translational Neuroscience and Mental Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Hunter Medical Research Institute  Newcastle New South Wales Australia"},{"name":"Schizophrenia Research Institute  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Crittenden","sequence":"additional","affiliation":[{"name":"Western New South Wales Local Health District  Bathurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Clark","sequence":"additional","affiliation":[{"name":"Priority Research Centre for Translational Neuroscience and Mental Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Hunter Medical Research Institute  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry J.","family":"Lewin","sequence":"additional","affiliation":[{"name":"Hunter New England Area Health Service  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Bucci","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.02.017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbl075"},{"key":"e_1_2_7_4_1","volume-title":"DSM\u2010IV: Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_7_5_1","unstructured":"Australian Government Department of Health and Ageing(n.d.).Mental health service in rural and remote areas program evaluation version 1.3. 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