{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:44:52Z","timestamp":1792215892823,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014653","name":"Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203308"],"award-info":[{"award-number":["NIHR203308"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Substance use and suicidality are prevalent among individuals at ultra\u2010high\u2010risk (UHR) of psychosis, yet their relationship remains unclear. This systematic review synthesises evidence on the relationship between substance use and suicidality\u2014comprising suicidal ideation, self\u2010harm, suicide attempts, and suicide deaths\u2014in the UHR population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pre\u2010registered systematic review (PROSPERO: CRD42024614852) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines. Systematic searches of Embase, Medline, PsycINFO, and Web of Science identified studies examining substance use and suicidality in individuals at UHR. Two reviewers independently extracted data and assessed quality using the Mixed Methods Appraisal Tool. Findings were narratively synthesised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve studies (13 papers;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092198) met inclusion criteria. Of 40 analyses, only 13 reported significant associations between substance use and suicidality, most of which were derived from a single study. Tobacco use showed the most consistent preliminary associations with suicidal ideation and self\u2010harm. Alcohol and cannabis were linked to ideation and self\u2010harm in some analyses, and cocaine to ideation only, particularly when continuous measures were used. In contrast, composite substance use variables were largely unrelated to suicide outcomes. Methodological quality varied, with major limitations including reliance on cross\u2010sectional data and the use of dichotomous substance use outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At present, there is insufficient high\u2010quality evidence to establish a reliable association between substance use and suicidality in individuals at UHR for psychosis. Rigorous longitudinal studies using validated, substance\u2010specific measures are needed to better understand these relationships and inform risk assessment and early intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eip.70236","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:46:27Z","timestamp":1785289587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Substance Use and Suicidality in People at Ultra\u2010High\u2010Risk of Psychosis: A Systematic Review"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2138-6236","authenticated-orcid":false,"given":"Alicia Tan Jia","family":"Hui","sequence":"first","affiliation":[{"name":"Faculty of Biology, Medicine &amp; Health, School of Health Sciences, Division of Psychology &amp; Mental Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee D.","family":"Mulligan","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine &amp; Health, School of Health Sciences, Division of Psychology &amp; Mental Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/eip.12100"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2010.10.011"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2025.2444"},{"key":"e_1_2_12_5_1","volume-title":"AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care","author":"Babor T. 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