Multisubstance Intoxication Among Schizophrenic Inpatients: Reply to Hyde

Koczapski, Andrzej B.; Ledwidge, Barry; Paredes, Jaime; Kogan, Claudio; Higenbottam, John

doi:10.1093/schbul/16.3.373

Cited by 10 publications

(4 citation statements)

References 10 publications

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“…A high caffeine intake appears to contribute to the complications of hyponatremia in some polydipsic patients (Kirubakaran 1986). In a 5-year followup of 89 long-term schizophrenia inpatients, Koczapski et al (1990) found 7 patients with a clear caffeine intoxication (some ate coffee) of whom 3 also had polydipsia with water intoxication. Moreover, water intoxication was only present in the heaviest caffeine consumers.…”

Section: Caffeine and Schizophreniamentioning

confidence: 99%

Caffeine Intake in Outpatients With Schizophrenia

Gurpegui¹,

Aguilar²,

Martínez-Ortega³

et al. 2004

Schizophrenia Bulletin

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Several studies suggest that caffeine intake is high in patients with schizophrenia and a few of them suggest that caffeine may contribute to schizophrenia symptomatology. None of these studies control for the effect of tobacco smoking, which is associated with induction of caffeine metabolism. Therefore, the high amount of caffeine intake among patients with schizophrenia may be due to their high prevalence of smoking. This is the first large study to explore whether caffeine intake in patients with schizophrenia is related to tobacco (or alcohol) use or to the severity of schizophrenia symptomatology. The sample included 250 consecutive consenting outpatients with a diagnosis of DSM-IV schizophrenia from Granada, Spain. Fifty-nine percent (147/250) of patients consumed caffeine. Current caffeine intake was associated with current smoking and alcohol use. As none of the females used alcohol, the association with alcohol was only present in males with schizophrenia. Among caffeine consumers, smoking was associated with the amount of caffeine intake. Cross-sectional schizophrenia symptomatology was not associated with caffeine intake.

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Section: Caffeine and Schizophreniamentioning

confidence: 99%

Caffeine Intake in Outpatients With Schizophrenia

Gurpegui¹,

Aguilar²,

Martínez-Ortega³

et al. 2004

Schizophrenia Bulletin

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“…Many substance-abusing individuals use multiple substances. Relatively little research has been done to address the consequences of multiple-substance abuse in schizophrenia, but it seems likely that substance interactions may further compromise health status, cognitive functioning, and psychiatric symptoms (Koczapski et al 1990). Substance use may also be associated with an increased risk of side effects, such as akathisia (Duke et al 1994) and TD (Binder et al 1987; Jeste et al 1995 a ).…”

Section: Substance Abuse and Dependencementioning

confidence: 99%

Medical Comorbidity in Schizophrenia

Jeste

Gladsjo

Lindamer

et al. 1996

Schizophrenia Bulletin

456

213

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The extent and consequences of medical comorbidity in patients with schizophrenia are generally underrecognized. Patients with comorbid conditions are usually excluded from research studies, although they probably represent the majority of individuals with schizophrenia. Elderly patients are especially likely to have comorbid disorders. In this article, we review selected literature on medical comorbidity in schizophrenia, including physical illnesses, substance use, cognitive impairment, sensory deficits, and iatrogenic comorbidity. Data from the University of California, San Diego Clinical Research Center on late-life psychosis are also presented. Older schizophrenia patients report fewer comorbid physical illnesses than healthy comparison subjects, but their illnesses tend to be more severe. These results suggest that schizophrenia patients may receive less than adequate health care. Substance abuse is more common in patients with schizophrenia than in the general population and may exacerbate psychiatric symptoms in these patients. Although generalized cognitive impairment is associated with schizophrenia, the main contributors to dementia in older patients are more likely to be comorbid neurological and other physical disorders, substance abuse, and medication side effects. Iatrogenic comorbidity results primarily from the use of neuroleptic (e.g., tardive dyskinesia) and anticholinergic (e.g., confusion) medications. Clinical and research recommendations are made for management of comorbidity in schizophrenia.

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“…Various theories have been proposed to explain elevated levels of caffeine consumption among individuals with a serious mental illness; including self-medication to treat symptoms such as anhedonia, drowsiness, and issues with concentration [ 14 ]; and to counteract the side effects of antipsychotic medications which can present in a similar way to the abovementioned symptoms [ 9 ]. However, few studies have explored caffeine use among individuals diagnosed with mental illness living in the community.…”

Section: Introductionmentioning

confidence: 99%

“Clozapine makes me quite drowsy, so when I wake up in the morning those first cups of coffee are really handy”: an exploratory qualitative study of excessive caffeine consumption among individuals with schizophrenia

et al. 2014

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BackgroundResearch has shown that individuals with schizophrenia use caffeine at higher rates than the general population; however, no qualitative research has been undertaken investigating problematic caffeine use and its effects on this population. This article explores the role of caffeine consumption in the lives of people with schizophrenia through a narrative analysis of the attitudes and beliefs associated with this practice, and how these, in turn, influence caffeine consumption.MethodsA qualitative study was undertaken with individuals who had previously scored in either a ‘moderate’ or ‘high’ risk category for caffeine use on the Alcohol, Smoking and Substance Involvement Screening Tool (ASSIST). In-depth interviews were undertaken with 20 individuals, and transcripts were analysed thematically to identify prominent perspectives.ResultsConsistent with previous literature, participants’ caffeine consumption was driven largely by its stimulating properties; however, participants also identified ‘cravings’ as an important motivating factor. Participants’ behaviours related to caffeine consumption seemed to be tempered by their previous experiences of consumption; if participants had experienced positive effects such as alertness or relaxation in the past, their use was maintained at a similar level or increased. Conversely, participants who anticipated negative consequences often altered their patterns of caffeine consumption; for example, by substituting caffeinated drinks that minimised or ceased their experience of negative side effects for those that directly caused such impacts. Overall, participants largely identified caffeine consumption as a highly meaningful activity, which provided structure to their day and facilitated opportunities for social interaction.ConclusionsThe inconsistencies between individuals’ beliefs about their health and the actual risk of harm associated with health-related behaviours present significant and ongoing challenges for the implementation of relevant and effective strategies for health promotion among individuals diagnosed with mental illness. As a starting point, it would be worthwhile for services engaging with people diagnosed with mental illness, and in particular schizophrenia, to consider implementing caffeine-related health literacy strategies to educate consumers about the risk of excessive caffeine consumption and the interactions between caffeine and antipsychotic medications.

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Multisubstance Intoxication Among Schizophrenic Inpatients: Reply to Hyde

Cited by 10 publications

References 10 publications

Caffeine Intake in Outpatients With Schizophrenia

Caffeine Intake in Outpatients With Schizophrenia

Medical Comorbidity in Schizophrenia

“Clozapine makes me quite drowsy, so when I wake up in the morning those first cups of coffee are really handy”: an exploratory qualitative study of excessive caffeine consumption among individuals with schizophrenia

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