Negative symptoms are associated with less alcohol use, craving, and “high” in alcohol dependent patients with schizophrenia

Batki, Steven L.; Leontieva, Luba; Dimmock, Jacqueline A.; Ploutz‐Snyder, Robert

doi:10.1016/j.schres.2008.06.020

Cited by 15 publications

(16 citation statements)

References 19 publications

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“…cognitive, social, affective, and communicative). This is in line with findings linking alcohol dependence attributes such as craving with global psychiatric symptom severity (Batki et al, 2008). Along with the greater degree of EPS after controlling for medication status (Potvin et al, 2006b), it may also explain the associated medication non-compliance we found, consistent with previous research (Buckley, 2006).…”

Section: Discussionsupporting

confidence: 92%

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Carrà

Johnson

Crocamo

et al. 2016

Psychiatry Research

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Little is known about the correlates of comorbid drug and alcohol dependence in people with schizophrenia outside the USA. We tested hypotheses that dependence on alcohol or drugs would be associated with more severe symptoms, and poorer psychosocial functioning and quality of life.The EuroSC Cohort study (N=1,204), based in France, Germany and the UK, used semi-structured clinical interviews for diagnoses, and standardized tools to assess correlates. We used mixed models to compare outcomes between past-year comorbid dependence on alcohol or drugs, controlling for covariates and modelling both subject and country level effects. Participants dependent on alcohol or drugs had fewer negative symptoms on PANSS than their non-dependent counterparts. However, those dependent on alcohol scored higher on PANSS general psychopathology than those who were not dependent, or dependent only on drugs. People suffering from schizophrenia dependent on drugs had poorer quality of life, more extrapyramidal side effects, and scored worse on GAF than those without dependence. People with alcohol dependence reported more reasons for noncompliance with medication, and poorer functioning on Global Assessment of Functioning (GAF), though not on Global Assessment of Relational Functioning (GARF). In people with schizophrenia, comorbid dependence on alcohol or drugs is associated with impaired clinical and psychosocial adjustment, and poorer quality of life.

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Section: Discussionsupporting

confidence: 92%

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Carrà

Johnson

Crocamo

et al. 2016

Psychiatry Research

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“…Among this population alcohol misuse has been linked to a range of adverse consequences including unemployment, lower education level and lower socioeconomic status 2. Studies examining the impact of alcohol misuse on various psychiatric symptoms among people with psychotic disorders report inconsistent findings 3 4…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%

Negative effect of alcohol use on mood among people with psychosis

Thornton

Kay‐Lambkin

2015

Evid Based Mental Health

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FROM: Barrowclough C, Eisner E, Bucci S, et al. The impact of alcohol on clinical outcomes in established psychosis: a longitudinal study. Addiction 2014;109:1297-305. WHAT IS ALREADY KNOWN ON THIS TOPICThe elevated prevalence of alcohol use disorders among people with psychotic disorders is well documented. 1 Among this population alcohol misuse has been linked to a range of adverse consequences including unemployment, lower education level and lower socioeconomic status. 2 Studies examining the impact of alcohol misuse on various psychiatric symptoms among people with psychotic disorders report inconsistent findings. 3 4 METHODS OF THE STUDYBarrowclough and colleagues investigated whether change in alcohol use was associated with change in psychiatric symptoms. They performed a secondary analysis of their randomised controlled trial of motivational interviewing and cognitive-behavioural therapy for people with psychosis and comorbid substance misuse. Participants were: aged 16 years or older; with a clinical diagnosis of a non-affective psychotic disorder; report alcohol misuse or illicit drug use; with a DSM-IV diagnosis of dependence or abuse of alcohol, drugs or both; have no significant history of organic factors; English speaking and have a fixed address. Participants recruited from secondary care services in the UK were split into two groups: those with a DSM-IV diagnosis of alcohol dependence or abuse (n=210) and those with a DSM-IV diagnosis of dependence or abuse for a substance other than alcohol (n=117). Psychiatric symptoms and substance use were assessed at baseline, 12 and 24 months. Participants' psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Anxiety and depression were assessed using two individual items on the PANSS. Case-notes were used to assess hospital admission and relapse in the past 12 months. Participants' substance use was assessed using the Alcohol Timeline Followback. Among participants with a diagnosis of alcohol dependence or abuse the authors used generalised estimating equation models to examine the effect of alcohol use on subsequent clinical outcomes.WHAT DOES THIS PAPER ADD ▸ Alcohol use was not associated with increased positive or negative symptoms of psychosis long-term (adjusted coefficient 0.0020, p=0.57). ▸ Depression is the principal harmful effect associated with alcohol use among people with psychotic disorders. (adjusted coefficient 0.0015, p=0.047). ▸ Improvements in the drinking patterns of people with psychotic disorders may result in improvements to their mood.LIMITATIONS ▸ A number of models have been proposed to explain the high co-occurrence of alcohol use and mental health disorders. This analysis is only attempted to test a secondary psychopathology model, where alcohol use increases psychiatric symptoms. It does not account for the impact of a secondary substance use model, where increased psychiatric symptoms lead to increased substance use, through a process of self-medication, or a common factor model where share...

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“…The most consistent finding within this phase of the illness is that AUDs are associated with increased positive symptoms (e.g., paranoia and auditory hallucinations), thought disorganization and depression [40,47,[74][75][76][77][78][79]. Furthermore, Swendsen and colleagues monitored substance use and positive symptoms in real time and found that cannabis use preceded positive symptoms and anxiousness, while alcohol use tended to follow eruptions of positive symptoms and anxiousness [80].…”

Section: Psychopathologymentioning

confidence: 99%

“…AUDs have also been associated with both greater [81] and lesser amounts [74,82] of negative symptoms.…”

Section: Review Smith and Csernanskymentioning

confidence: 99%

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Clinical implications of alcohol-use disorders in schizophrenia

Smith¹,

Csernansky²

2012

Neuropsychiatry

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Practice pointsThe clinical course of schizophrenia can be characterized by four stages: a premorbid stage often recognized in individuals with family histories of the disorder; a prodromal stage where subclinical symptoms are first expressed; the first episode of schizophrenia when psychosis first appears in its full form; and a maintenance stage of schizophrenia when there may be active or residual psychotic symptoms.Each stage of the clinical course of schizophrenia is characterized by elevated rates of alcohol-use disorders (AUDs).AUDs in this clinical population may be linked to neurobiological abnormalities within the reward system that may have functional implications for both addiction and schizophrenia.AUDs in this clinical population may also be linked with personality characteristics that predispose them to be sensitive to stress, to use ineffective coping skills and to turn to alcohol to relieve dysphoria.Research on AUDs in the first two stages, although minimal, suggests that prodromal individuals with AUDs are at risk for increases in perceptual abnormalities and strange behaviors.Research on AUDs in the latter two stages of schizophrenia suggests that AUDs are associated with exacerbated psychopathology, medication noncompliance, cognitive dysfunction, poor community functioning and poor physical health outcomes.The design of interventions for premorbid and prodromal individuals would benefit from considering the evidence-based implications of alcohol at these specific stages of the disorder.Naltrexone and disulfirate currently have US FDA approval as treatments for AUDs, and have shown some efficacy in individuals with schizophrenia. However, the use of these drugs has not yet been evaluated at all stages of the disorder.For reprint orders, please contact: reprints@futuremedicine.com

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Negative symptoms are associated with less alcohol use, craving, and “high” in alcohol dependent patients with schizophrenia

Abstract: Background-Alcohol use disorders (AUDs) frequently co-occur with and exacerbate schizophrenia, yet the specific relationships between schizophrenia symptoms and alcohol use remain unclear.

Cited by 15 publications

References 19 publications

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Negative effect of alcohol use on mood among people with psychosis

Clinical implications of alcohol-use disorders in schizophrenia

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