Under-reporting of drug use among individuals with schizophrenia: prevalence and predictors

Bahorik, Amber L.; Newhill, Christina E.; Queen, Courtney C.; Eack, Shaun M.

doi:10.1017/s0033291713000548

Cited by 46 publications

(36 citation statements)

References 54 publications

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“…This study used self-reports of tobacco use and smoking as in most epidemiological studies. Previous research has shown that information obtained from patients and informants underestimates substance use when compared to laboratory analysis [40,41]. Only data from males were used in the analysis of association between tobacco use and antipsychotics.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotic medication and tobacco use among outpatients with schizophrenia: a cross-sectional study

2014

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BackgroundMany studies have shown that the prevalence of smoking in schizophrenia is higher than in the general population. Biological, psychological and social factors influence smoking in patients with schizophrenia.MethodsThe study was carried out in psychiatry outpatient clinics in a tertiary care hospital in Sri Lanka. Every third patient was selected using systematic sampling from patients diagnosed with schizophrenia according to ICD-10 clinical criteria. Smoking behaviours were assessed using self-reports. Severity of illness was assessed using Brief Psychiatric Rating Scale (BPRS). Fagerstrom Test for Nicotine Dependence assessed level of dependence. Readiness to Change Questionnaire assessed motivation to change smoking behaviour.ResultsThe sample consisted of 306 patients with schizophrenia. Mean age was 38.93 years (SD 10.98). There were 148 males (48.4%). Mean duration of illness was 12.63 years (SD 8.38). Current medication was oral atypical antipsychotics 103, clozapine 136, oral typicals 29 and depot typicals 38. Prevalence of tobacco use among males was 30.41% (95% CI 22.91 to 37.90) and among females 1.90% (95% CI -0.25 to 4.05). Prevalence of current smoking among males was 20.27% (95% CI 13.72 to 26.82). None of the females smoked. Prevalence of smokeless tobacco use among males was 10.14 (95% CI 5.22 to 15.05) and among females 1.90 (95% CI -0.03 to 4.05). When patients treated with clozapine were excluded from the analysis, prevalence of tobacco use was 41.6% among males and 3.2% among females and prevalence of smoking was 29.9% among males. Prevalence of tobacco use was lowest in patients treated with clozapine 18.31 (95% CI 9.09 to 27.53) and highest in those treated with depot antipsychotics 47.83 (95% CI 25.74 to 69.91).ConclusionsPrevalence of smoking was less than in many countries. This is influenced by prevalence in the general population and low affordability. Risk of tobacco use was significantly less among patients treated with clozapine.

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Section: Discussionmentioning

confidence: 99%

Antipsychotic medication and tobacco use among outpatients with schizophrenia: a cross-sectional study

2014

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“…Our substance use measure was, admittedly limited by self-report (use/no use), and, as substance use was not quantified, we are precluded from drawing conclusions about quantity/frequency. Given the potential for under-reported substance use, our findings may underestimate the actual rates of use (Bahorik et al, 2014). Biomedical measures of drug-use had the largest amount of missing data in the CATIE and recent investigations have cautioned that using multiple measures to confirm substance use may result in overestimates (Johnson et al, 2015).…”

Section: Discussionmentioning

confidence: 80%

Motivation deficits and use of alcohol and illicit drugs among individuals with schizophrenia

Bahorik

Greeno

Cochran

et al. 2017

Psychiatry Research

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This study examined the impact of substance use on intrinsic motivation and evaluated the association between intrinsic motivation and substance use recovery among individuals with schizophrenia. Alcohol and illicit drug use and intrinsic motivation were evaluated at baseline and 6-months for 1434 individuals with schizophrenia from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) using self-rated substance use assessments and a derived motivation measure from the Heinrichs-Carpenter Quality of Life Scale. Results revealed patients had moderate motivation deficits overall and a considerable number were using alcohol or illicit drugs at baseline (n = 576; 40.2%). Regression models at baseline showed patients with low levels of motivation had higher odds of substance use and those who were using substances had greater motivation deficits. At 6-months, substance using patients continued to demonstrate greater motivation deficits; however, those with high levels of motivation exhibited a greater reduction in their use of substances. Findings remained significant after adjusting for clinical confounds and were consistent across any substance, alcohol, and cannabis use. Our results emphasize concerns about substance use compounding motivation deficits in schizophrenia, and suggest that disentangling the motivation-substance use relationship in schizophrenia may facilitate efforts aimed at ameliorating these challenges and improving outcomes.

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“…A psychosis group without drug use (n ¼91), and a group with both psychosis and concurrent drug use (n ¼32). To further decrease false negative drug users all the patients' clinical records were carefully examined by a trained psychiatric research nurse for use of cannabis as a marker of drug use, as it is possible that cannabis use could be underreported (Bahorik et al, 2014). All 32 patients in the psychosis group with drug use had a lifetime history of cannabis use.…”

Section: Drug Groupsmentioning

confidence: 99%

Cognitive changes in patients with acute phase psychosis—Effects of illicit drug use

Helle¹,

Gjestad²,

Johnsen³

et al. 2014

Psychiatry Research

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Illicit drug use may influence cognition in non-affective psychosis. Previous studies have shown better cognition in psychosis with illicit drug use as compared to psychosis only. Possibly, illicit drug using patients have more transient drug-related cognitive deficits. Thus, the aim of the present study was to examine cognitive change the first weeks after admission to a psychiatric emergency ward, expecting more cognitive improvement at follow-up in the illicit drug group as compared to psychosis only. Patients with acute non-affective psychosis with (26%) and without illicit drug use were examined at baseline (n=123) and follow-up (n=67), with alternative forms of the Repeatable Battery for the Assessment of Neuropsychological Status. Latent Growth Curve models, controlling for cognition at baseline and age differences between the groups, were used to analyze cognitive change. The illicit drug using patients showed the largest improvement in cognition, especially among the youngest patients. Younger patients with non-affective psychosis and illicit drug use showed more cognitive improvement the first weeks after acute psychosis as compared to psychosis only. This suggests that the illicit drug users constitute a sub-group with less stable cognitive deficits and less cognitive vulnerability.

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Under-reporting of drug use among individuals with schizophrenia: prevalence and predictors

Cited by 46 publications

References 54 publications

Antipsychotic medication and tobacco use among outpatients with schizophrenia: a cross-sectional study

Antipsychotic medication and tobacco use among outpatients with schizophrenia: a cross-sectional study

Motivation deficits and use of alcohol and illicit drugs among individuals with schizophrenia

Cognitive changes in patients with acute phase psychosis—Effects of illicit drug use

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