Self-reported financial performance of people with recent-onset psychosis- A comparison with matched controls and the role of scarcity and substance use

Background Adequate financial performance is essential. Problems in this area can contribute to serious financial problems. People with psychosis show difficulties with financial performance, which can be affected by contextual factors such as financial scarcity and substance use. Prior research mainly relied on standardized tests, which capture performance under structured, optimal conditions, not necessarily in everyday life. Additionally, evidence for people in the recent-onset phase of psychosis (ROP) is lacking. This study aims to provide a detailed exploration of self-reported everyday financial performance in people with ROP, to exploratively re-evaluate this performance one-year later, and to examine associations with financial scarcity and substance use. Method Thirty-five people with ROP and 39 matched controls completed questionnaires on financial performance, financial scarcity, and substance use. Financial performance was reassessed after one year in the ROP group (n = 23). Results People with ROP reported poorer financial performance than controls (p < .001; d = 1.32); a self-evaluation that appeared similar one year later (p = .65; d = .18). They also reported greater financial scarcity (p < .001; d = −1.61) and more substance use-related problems (p < .001; d = .44). Financial scarcity was significantly associated with financial performance in controls, not in people with ROP. No significant associations were found with substance use. Conclusions Self-reported difficulties in financial performance and financial scarcity can already emerge in the early stages of psychosis. Addressing daily-life financial functioning in mental healthcare is essential to support timely recognition of potential financial problems and referral to targeted interventions.