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

Abstract

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.

Facial emotion recognition in schizophrenia: An exploratory study on the role of comorbid alcohol and substance use disorders and COMT Val158Met

“…Behaviours associated with substance misuse may require certain cognitive abilities; thus, a better cognition among patients with dual disorders would be a primary characteristic, and not secondary to the consumption of particular substances (Joyal, Hallé, Lapierre, & Hodgins, ). Consistently, in our sample, a lower impairment on negative symptoms, a common feature for subjects with comorbid schizophrenia and SUDs (Carrà et al, ), was associated with better FER performances. Also for this domain, the cognitive paradox of dually diagnosed subjects might be true.…”

“…In addition, our recent meta‐analysis confirmed the existence of severe deficits in FER also in subjects with alcohol and substance use disorders (AUDs/SUDs) relative to healthy participants (Castellano et al, ). However, AUDs and SUDs are highly comorbid in people with schizophrenia (e.g., Carrà et al, , ). Thus, individuals with schizophrenia who misuse psychoactive substances should arguably display an additional impairment in FER.…”

Analysis of psychotropic drug-related deaths in south Osaka

“…It appears that individuals living on their own could not properly use drugs, and it was revealed that there were many cases with multiple drug and alcohol/drug combination use. 45 Our results indicate that as a pharmaceutical factor, the use of psychotropic drugs to treat mental illness has a substantial effect on death. 46 , 47 …”

Effectiveness of Community-Based Interventions for Patients with Schizophrenia: A Study Protocol for a Systematic Review

“…Increasing heterogeneity increases the value of I 2 , which allows for the selection of a fixed-effect model or a random-effect model based on the I 2 50% rate [21]; a fixed effect model will be selected if it presents heterogeneity results below 50%, and if heterogeneity is higher than 50%, a random effect model will be selected, and subgroup analysis will be performed. Factors expected to contribute to heterogeneity include the clinical characteristics of the patients, including the severity of the disease, the comorbidity, the exact diagnosis, and the duration of the disease, which have all been reported to have an effect on treatment in previous studies [22][23][24][25]. Therefore, the subgroups will be set up in consideration of clinical characteristics and types of interventions, so that the likelihood of statistical errors are reduced.…”