Substance use and schizophrenia: Adverse correlates in the CATIE study sample

Kerfoot, Karin; Rosenheck, Robert A.; Petrakis, Ismene L.; Swartz, Marvin S.; Keefe, Richard S.E.; McEvoy, Joseph P.; Stroup, T. Scott

doi:10.1016/j.schres.2011.07.032

Cited by 60 publications

(38 citation statements)

References 31 publications

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“…In contrast to many previous US samples (e.g., Swarz et al, 2006b;Talamo et al, 2006;Kerfoot et al, 2011), but consistent with some European studies (e.g., Dervaux et al, 2002), we did not find significantly higher PANSS-positive scores in our sample of schizophrenic subjects with comorbid dependence. However, more recent investigations from the USA, using latent class analysis based on the CATIE study (Tsai and Rosenheck, 2013) and the Molecular Genetics of Schizophrenia (MGS1) Collaboration study (Kerner, 2015) have also reported that comorbid substance use was unrelated to any specific pattern of positive symptoms.…”

Section: Discussionsupporting

confidence: 90%

“…Notably, there was no excess of PANSS positive symptoms in people suffering from schizophrenia with comorbid alcohol or drug dependence. Findings of fewer negative symptoms in comorbid substance users tally with the bulk of the literature (e.g., Swartz et al, 2006b;Kerfoot et al, 2011), which suggests a correspondence between the most severe dependence syndromes and attempts to alleviate dysphoria (e.g., Potvin et al, 2006a;Talamo et al, 2006). Nevertheless, fewer negative symptoms may reflect better premorbid functioning, in that drugs-using patients may have superior social skills in order to be able to acquire and sustain a drug habit (Salyers and Mueser, 2001).…”

Section: Discussionmentioning

confidence: 57%

“…In addition, the assessment of substance use has often been inadequate, with relatively few studies making full diagnostic assessments (Drake et al, 1993). Moreover, correlates have been described in relation, variously, to point, period and life-time prevalence (Goldfinger et al, 1996), and dependence disorders involving alcohol and other drugs have frequently not been distinguished from DSM-IV abuse (ICD-10 harmful use), though the consequences of dependence may be much more severe than those of harmful use in people with schizophrenia (Olfson et al, 2002;Potvin et al, 2006a;Kerfoot et al, 2011;.…”

Section: Introductionmentioning

confidence: 99%

“…The characteristics of clinical populations with both schizophrenia and substance use disorders are universally worse than their non-abusing counterparts (Margolese et al, 2004;Kerner, 2015), including clinical (Kerfoot et al, 2011;Jones et al, 2011), physical (Rosenberg et al, 2001) and legal outcomes. Nonetheless, it has been suggested that psychosocial functioning and quality of life (QoL) might actually be better in substance-abusing people with schizophrenia than in those who are abstinent, given that they need the skills to engage with drugdealers in order to secure supplies (Salyers and Mueser, 2001;Swartz et al, 2006b).…”

Section: Introductionmentioning

confidence: 99%

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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: 90%

Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

show abstract

“…In this analysis, diagnoses of substance abuse and alcoholism were more frequent in the seriously mentally ill patients (OAS) than in the primary care control group (PRISM) as has been reported in other studies (28–30). However the frequencies of most comorbid medical conditions including such chronic conditions as diabetes and hypertension for the seriously mentally ill patients (OAS), although high, were similar to those in our comparative group of medical outpatient attendees (PRISM).…”

Section: Discussionsupporting

confidence: 74%

Comorbidity Profile and Healthcare Utilization in Elderly Patients with Serious Mental Illnesses

Hendrie¹,

Lindgren²,

Hay³

et al. 2013

The American Journal of Geriatric Psychiatry

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Objectives Patients with serious mental illness are living longer. Yet there remain few studies that focus on health care utilization and its relationship to comorbidities in these elderly mentally ill patients. Design Comparative study. Information on demographics, comorbidities and health care utilization were taken from an electronic medical record system. Setting Wishard Health Services senior care and community mental health clinics. Participants Patients age 65 years and over-255 patients with serious mental illness (schizophrenia, major recurrent depression and bipolar illness) attending a mental health clinic and a representative sample of 533 non-demented patients without serious mental illness attending primary care clinics. Results Patients having serious mental illness had significantly higher rates of medical emergency room visits (p=0.0027) and significantly longer lengths of medical hospitalizations (p<0.0001) than did the primary care control group. The frequency of medical comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, thyroid disease, and cancer were not significantly different between the groups. Hypertension was lower in the mentally ill group (p<0.0001). Reported falls (p<0.0001), diagnoses of substance abuse (p=0.02), and alcoholism (p=0.0016) were higher in the seriously mentally ill. The differences in health care utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Conclusions Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest the elderly seriously mentally ill remain a vulnerable population requiring an integrated model of health care.

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