Crouse JJ1, Chitty KM2, Iorfino F1, White D1, Nichles A1, Zmicerevska N1, Guastella AJ1, Moustafa AA3,4,5, Hermens DF1,6, Scott EM1,7, Hickie IB1.Author information1Youth Mental Health Team, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.2Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Pharmacology, The University of Sydney, Camperdown, NSW, Australia.3School of Social Sciences and Psychology, Western Sydney University, Milperra, NSW, Australia.4MARCS Institute for Brain, Behaviour and Development, Milperra, NSW, Australia.5Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar.6Sunshine Coast Mind and Neuroscience-Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.7Notre Dame Medical School, Sydney, NSW, Australia.Abstract

Neuropsychiatric disorders (including substance misuse) are associated with the greatest burden of functional disability in young people, and contributory factors remain poorly understood. Early-onset substance use is one candidate risk factor which may inform functional prognosis and facilitate direction of interventions aiming to curtail impairment. Accordingly, we modelled associations between early-onset use of alcohol, tobacco, cannabis and amphetamine-type stimulants (ATSs) and longitudinal socio-occupational functioning (indexed by the Social and Occupational Functioning Assessment Scale) in an observational cohort presenting to early intervention mental health services. A clinical proforma collated demographic, clinical, and socio-occupational information for up to 60-months from presentation to services in young people aged 17-30. Of the wider cohort (n

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