Substance Use in Young Adults With Schizophrenic Disorders

Test, Mary Ann; Wallisch, Lynn S.; Allness, Deborah J.; Ripp, Kathryn

doi:10.1093/schbul/15.3.465

Cited by 202 publications

(139 citation statements)

References 22 publications

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“…Co-morbid individuals with family members who are not users often distance themselves from their families when they begin substance use (Test, Wallish, Allness, & Ripp, 1989;Drake et al, 1998). In their stead, mutual substance use can form a basis for new friendships, especially for those who might otherwise have trouble socializing due to mental illness symptoms (Drake et al, 1998).…”

Section: How Social Network and Social Support Systems Mattermentioning

confidence: 99%

Disappearing acts: The social networks of formerly homeless individuals with co-occurring disorders

Hawkins

Abrams

2007

Social Science & Medicine

129

143

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Studies of the social lives of men and women living with co-occurring disorders (substance abuse and serious mental illness) suggest that social networks critically influence recovery. In this paper, we examine some of the reasons that the social networks of individuals with co-occurring disorders are small, and the impact of small networks for this population. Using a social capital framework with cross-case analysis, we analyze 72 in-depth qualitative interviews with 39 formerly homeless mentally ill men and women who were substance abusers. All were participants in the New York Services Study (HYSS), a federally funded study of mentally ill adults in New York City. The patterns suggest that networks shrunk because 1) social network members died prematurely, 2) study participants withdrew or pushed others away, and 3) friends and family members faced so many obstacles of their own that they could not provide resources for the study participants. We suggest that as networks diminished, some participants responded by attempting to rebuild their networks, even if the networks provided negative social capital, and others isolated themselves socially to escape the pressures and disappointments of interaction. KeywordsUSA; New York Services Study (NYSS); social capital; social networks; co-occurring disorders; mental illness; homeless; substance abuse The role of family and friends for individuals with co-occurring disorders (substance abuse and serious mental illness) in recovery is complex and often ambiguous. While close friends and family members can forge ties that produce social capital in the form of significant financial, emotional, and in-kind support to individuals with co-occurring disorders, they can also pose specific problems. Studies of the social lives of co-morbid individuals suggest that social support from family and friends can decrease symptomatology

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Section: How Social Network and Social Support Systems Mattermentioning

confidence: 99%

Disappearing acts: The social networks of formerly homeless individuals with co-occurring disorders

Hawkins

Abrams

2007

Social Science & Medicine

129

143

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“…Test, Wallisch, Allness, and Ripp (1989) reported that 86% of their patients with schizophrenia drank coffee, averaging 6 cups per day; this quantity has been associated with caffeine withdrawal and related disorders (American Psychiatric Association, 1994). In contrast, only 9% of the general population consumes as much caffeine (Greden, Fontaine, Lubetsky, & Chamberlain, 1978).…”

Section: Licit Substance Use Among Psychiatric Outpatients: a Qualitamentioning

confidence: 99%

Use of legal drugs by psychiatric outpatients: Benefits, costs, and change

Carey

Maisto

Carey

et al. 1999

Cognitive and Behavioral Practice

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Caffeine, nicotine, and alcohol use by persons with a severe mental illness occurs frequently but is poorly understood. We used qualitative methods to elicit information regarding the functional relationships between legal substance use and its antecedents and consequences. This report summarizes responses provided by 37 psychiatric outpatients who participated in focus groups and key informant interviews regarding the use and functions of alcohol, caffeine, and nicotine. We describe major themes regarding positive and negative consequences, triggers for use, change efforts, and offer observations regarding substance use in this under-served population. Licit Substance Use Among Psychiatric Outpatients: A Qualitative AnalysisCaffeine, nicotine, and alcohol are used extensively by persons with severe mental illnesses (SMI), often at rates that far exceed rates found in the general population. Test, Wallisch, Allness, and Ripp (1989) reported that 86% of their patients with schizophrenia drank coffee, averaging 6 cups per day; this quantity has been associated with caffeine withdrawal and related disorders (American Psychiatric Association, 1994). In contrast, only 9% of the general population consumes as much caffeine (Greden, Fontaine, Lubetsky, & Chamberlain, 1978). Excessive caffeine use can have deleterious effects on mental status, increasing anxiety and depression (Greden et al., 1978;Winstead, 1976), and exacerbating psychotic symptoms in persons with schizophrenia (Carey & Carey, 1989;Mikkelsen, 1978).As many as three-quarters of patients with schizophrenia smoke (Goff, Henderson, & Amico, 1992;Ziedonis, Kosten, Glazer, & Frances, 1994) compared to one-quarter of the general population. In addition to the established risks for cancer and heart disease, additional deleterious effects may accrue for smokers receiving psychiatric treatment. Cigarette smoking increases hepatic enzyme action, hastening the elimination of drugs that depend on hepatic metabolism, thereby reducing plasma concentration of some therapeutic drugs (Perry, Miller, Arndt, Smith, & Holman, 1993). Persons with schizophrenia who smoke have also received higher ratings of positive symptoms (Goff et al., 1992;Ziedonis et al., 1994). Although cause and effect relationships are not clear, nicotine may exacerbate psychotic symptoms and reduce the effectiveness of antipsychotic medications.Alcohol use by the SMI is also common. Among persons diagnosed with schizophrenia, onethird meet criteria for an alcohol use disorder, representing an odds ratio of 3.3. Similar odds ratios for alcohol use disorder range from 1.9 among persons with mood disorders (22%) to 1.5 for persons with anxiety disorders (18%; Mueser, Bellack, & Blanchard, 1992 Drake, Osher, & Wallach, 1989), exacerbation of delusions and hallucinations (Noordsy et al., 1991) and depressive symptoms (Cuffel & Chase, 1994). Larger studies have also confirmed that comorbid alcohol abuse increases the likelihood of violent behavior (Swanson, 1993) among persons with a SMI.Drinking ...

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Section: Introductionmentioning

confidence: 99%

“…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).…”

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confidence: 99%

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

et al. 2001

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Objective-The high rates of comorbid substance use disorders among persons living with severe and persistent mental illness (SPMI) have increased interest in assessing and enhancing motivation to change substance misuse in this population. This study provides evidence for the psychometric adequacy of three self-report measures of readiness-to-change.Method-The sample consisted of 84 persons (65% men) with co-occurring substance abuse or dependence and an SPMI. After a psychiatric assessment, participants completed three measures of readiness-to-change, which yielded seven subscales: (1) the Stages of Change Readiness and Treatment Eagerness Scale (ambivalence about change, recognition of substance-related problems, taking steps), (2) Decisional Balance Scale (pros of using, cons of using) and (3) the Alcohol and Drug Consequences Questionnaire (costs of quitting, benefits of quitting).Results-All of the subscales were stable over time, and 6 of the 7 subscales demonstrated excellent internal consistency. Reliability indices were comparable when analyses were repeated on subsets of participants defined by diagnosis, cognitive function, positive symptoms and negative symptoms. A pattern of theoretically meaningful intercorrelations provided convergent evidence of validity, and a general lack of relationships with demographic variables and indices of psychiatric status provided discriminant evidence of validity. These findings support efforts to quantify readiness-to-change substance misuse among persons with an SPMI.Substance use disorders are highly prevalent among persons with schizophrenia and other major mental illnesses. Persons with major (Axis I) mental disorders have three times the risk of drug or alcohol diagnoses compared to the rest of the population (Regier et al., 1990). Persons with schizophrenia represent a particularly high risk group for problems related to substance use. 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). Individuals enrolled in outpatient treatment and "dually diagnosed" with psychiatric and substance use disorders exhibit poor (Keck, McElroy, Strakowski, Bourne, & West, 1997;Owen, Fischer, Booth, & Cuffel, 1996;Pristach & Smith, 1990), report more severe psychiatric symptoms (Carey, Carey, & Meisler, 1991), and involve themselves minimally in structured treatment programs Lehman, Herron, Schwartz, & Myers, 1993;Richardson, Craig, & Haugland, 1985). This pattern of poor treatment compliance and exacerbated symptoms leads ...

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Substance Use in Young Adults With Schizophrenic Disorders

Cited by 202 publications

References 22 publications

Disappearing acts: The social networks of formerly homeless individuals with co-occurring disorders

Disappearing acts: The social networks of formerly homeless individuals with co-occurring disorders

Use of legal drugs by psychiatric outpatients: Benefits, costs, and change

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

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