How does drug and alcohol misuse develop among people with psychotic illness? A literature review

Phillips, P. A.

doi:10.1007/s001270170044

Cited by 75 publications

(55 citation statements)

References 46 publications

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“…Dual diagnosis of alcohol and/or drug misuse and psychotic illness has been identified in the past decade as an important clinical problem in service provision for those with severe mental illnesses, and is associated with substantial social difficulties for this group (Dixon, 1999;Gearon et al, 2001;Phillips & Johnson, 2001;Murray et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

Phillips¹,

Johnson²

2003

Psychiatr. bull.

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Aims and MethodWard staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients.Results264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with ‘dual diagnosis' was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission.Clinical ImplicationsIt appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.

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Section: Discussionmentioning

confidence: 99%

Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

Phillips¹,

Johnson²

2003

Psychiatr. bull.

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“…However, the scientific debate about amphetamine-induced psychosis is ongoing, and it remains unclear whether the use of amphetamine-like substances can actually cause a psychotic disorder in an otherwise healthy individual, or whether it triggers the onset of schizophrenia in an individual with high vulnerability to the disease (Phillips & Johnson, 2001;Poole & Brabbins, 1996). Increased drug use among psychotic patients may also result from their attempt to counteract nonspecific physical symptoms or side effects of neuroleptics (Mueser, Drake & Wallach, 1998).…”

Section: Khat and Psychosis: Theoretical Backgroundmentioning

confidence: 99%

Chronic khat use and psychotic disorders: A review of the literature and future prospects

Odenwald¹

2007

SUCHT

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Aims: In recent decades, the traditional habit of chewing the khat leaves, which contain the amphetamine-like cathinone, has undergone profound changes in African and Arab countries, from a socially regulated use pattern to uncontrolled consumption. This is of special public mental-health concern. In this article, a review of the scientific literature on the relationship between khat use and psychosis is provided. Results: Several case studies, but only a few group and community-based studies, have addressed this topic. The studies show inconsistent results, have methodological problems, and fail to report quantitative results. Many important questions remain unaddressed. Conclusions: The frequently stated association between khat use and psychosis contrasts with the small number of sound studies. Currently, only a few conclusions can be drawn, that excessive khat use can cause brief psychotic disorders and that people with a preexisting vulnerability should be discouraged to use it. The direction of causality between general psychopathology and khat use remains unclear. This review confirms the need for quantitative, controlled, and longitudinal studies,

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“…Debate about the reasons for this association [4•,5•,6-10•, [11][12][13] has suggested the following major hypotheses to explain it: 1) that the comorbidity between cannabis use and psychosis is due to common factors that increase the risk of both; 2) that cannabis use causes psychoses, including schizophrenia, in persons who would not otherwise develop the illness; 3) that cannabis use precipitates schizophrenia only among persons who were vulnerable to developing schizophrenia (eg, through family history of schizophrenia); 4) that cannabis use by persons with schizophrenia worsens symptoms or prolongs the illness, so that remission of psychotic symptoms is less likely; and 5) that those with schizophrenia are more susceptible to developing heavy or problematic use of cannabis if they begin using it.…”

Section: Introductionsmentioning

confidence: 99%

Cannabis and psychosis

Degenhardt

Hall

2002

Curr Psychiatry Rep

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There has been considerable debate about the reasons for the association observed between cannabis use and psychosis in both clinical and general population samples. Among the hypotheses proposed to explain the association are the following: 1) common factors explain the co-occurrence; 2 cannabis causes psychosis that would not have occurred in the absence of cannabis use; 3) cannabis precipitates psychosis among persons who were vulnerable to developing the disorders; 4) cannabis use worsens or prolongs psychosis among those who have already developed the disorder; and 5) that persons with psychosis are more likely to become regular or problematic cannabis users than persons without psychosis. This article evaluates the evidence on each of these hypotheses, including recent research on the role of the cannabinoid receptor system in schizophrenia. The evidence suggests that common factors do not explain the comorbidity between cannabis use and psychosis, and it is unlikely that cannabis use causes psychosis among persons who would otherwise not have developed the disorder. The evidence is more consistent with the hypotheses that cannabis use may precipitate psychosis among vulnerable individuals, increase the risk of relapse among those who have already developed the disorder, and may be more likely to lead to dependence in persons with schizophrenia.

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How does drug and alcohol misuse develop among people with psychotic illness? A literature review

Abstract: There is a need for further research, especially concerning the social contexts of substance and alcohol misuse and the ways in which patterns of misuse develop among people with schizophrenia and other psychotic illnesses.

Cited by 75 publications

References 46 publications

Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

Chronic khat use and psychotic disorders: A review of the literature and future prospects

Cannabis and psychosis

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