Prevalence of Substance Abuse in Schizophrenia: Demographic and Clinical Correlates

Abstract

Methodological issues involved in assessing the prevalence of substance abuse in schizophrenia are discussed, and previous research in this area is comprehensively reviewed. Many studies suffer from methodological shortcomings, including the lack of diagnostic rigor, adequate sample sizes, and simultaneous assessment of different types of substance abuse (e.g., stimulants, sedatives). In general, the evidence suggests that the prevalence of substance abuse in schizophrenia is comparable to that in the general population, with the possible exceptions of stimulant and hallucinogen abuse, which may be greater in patients with schizophrenia. Data are presented on the association of substance abuse with demographics, diagnosis, history of illness, and symptoms in 149 recently hospitalized DSM-III-R schizophrenic, schizophreniform, and schizoaffective disorder patients. Demographic characteristics were strong predictors of substance abuse, with gender, age, race, and socioeconomic status being most important. Stimulant abusers tended to have their first hospitalization at an earlier age and were more often diagnosed as having schizophrenia, but did not differ in their symptoms from nonabusers. A history of cannabis abuse was related to fewer symptoms and previous hospitalizations, suggesting that more socially competent patients were prone to cannabis use. The findings show that environmental factors may be important determinants of substance abuse among schizophrenic-spectrum patients and that clinical differences related to abuse vary with different types of drugs.

Quality of life among dually diagnosed and non-substance-using male schizophrenia outpatients

“…This was not consistent with studies reporting that dual [17][18][19][20][21] Schizophrenia patients with no SUD comorbidity showed significantly higher levels of employment, which is consistent with most of the studies in the literature. [20][21][22] Substance use is thought to impair occupational activities and function. The primary substances used were alcohol and cannabis.…”

Measuring readiness-to-change substance misuse among psychiatric outpatients: I. Reliability and validity of self-report measures.

“…Among all persons with a diagnosis of schizophrenia, 47% meet lifetime criteria for a substance use disorder (Regier et al, 1990). This prevalence rate is often higher in samples of schizophrenic patients in treatment (Mueser et al, 1990;Test, Wallisch, Allness, & Ripp, 1989).…”

“…Among all persons with a diagnosis of schizophrenia, 47% meet lifetime criteria for a substance use disorder (Regier et al, 1990). This prevalence rate is often higher in samples of schizophrenic patients in treatment (Mueser et al, 1990;Test, Wallisch, Allness, & Ripp, 1989).A diagnosis of substance abuse or dependence impairs both the process and outcome of mental health treatment. Symptom exacerbation and psychiatric admissions have both been linked to acute drug use in outpatients with a severe and persistent mental illness (SPMI), such as schizophrenia (Haywood et al, 1995;Shaner et al, 1995).…”

Mental health nurses’ attitudes towards the physical health care of people with severe and enduring mental illness: The development of a measurement tool

“…Other important health behaviours also contribute to increased rates of preventable health problems. For example, people with SMI are likely to eat less nutritionally balanced diets and are less physically active than the general population (McCreadie, 2003;Kilbourne et al, 2007) and also have higher rates of alcohol and illicit drug misuse (Mueser et al, 1990;Drake and Meuser, 2002). Psychotropic medications have a number of negative effects on physical health: central obesity, dyslipedemia, and insulin resistance are frequently reported in patients prescribed antipsychotic medications (Haddad, 2004;Holt et al, 2004).…”