Violence and Severe Mental Illness: The Effects of Substance Abuse and Nonadherence to Medication

Course and Predictors of Physical Aggressive Behaviour after Discharge from a Psychiatric Inpatient Unit: 1 Year Follow-up

“…Fourteen of these offenders abused alcohol and/or drugs, and other seven were probable abusers. Similar effects were demonstrated in the United States (Swartz et al 1998).…”

“…In literature, important predictive factors for short-term aggressive behaviour are: violence that precedes admission (Tardiff et al 1997;Arango et al 1999); high re-admission rate and involuntary hospitalization (Nijman et al 2002); poor insight (Arango et al 1999); a history of one or more violent episodes at some time in the past (Tardiff et al 1997) and substance abuse (Walsh et al 2004). Other studies show a strong correlation between substance abuse and aggressiveness (Swartz et al 1998). It seems that the association between major mental disorders and violent behaviour may be strengthened by comorbidity with substance abuse.…”

Neurocognitive Functioning of Individuals With Schizophrenia: Using and Not Using Drugs

“…2 Using drugs portends a debilitating course of illness for individuals with schizophrenia across a number of clinical and functional domains. 5,9,[18][19][20][21][22][23][24] Worsened outcomes on cognitive function would be expected for adults with schizophrenia who use drugs, because substance use is known to exacerbate psychotic symptomatology and undermine treatment effectiveness. 18,19,21 Cannabis has adverse effects on brain function, 90,91 and cocaine has negative effects on learning and memory.…”

“…10,11 Not surprisingly, the examination of cognitive deficits has become a primary focus of the current research on drug abuse in schizophrenia. 12,13 Although cognitive deficits are already present in first-episode patients, [14][15][16][17] and drug use results in problematic consequences for adults with schizophrenia, [18][19][20][21][22][23][24] major research has surprisingly shown that drug use is at times associated with improved, rather than impaired, cognitive function in these individuals. [25][26][27][28][29][30][31][32][33][34][35][36] In fact, findings of recent meta-analyses show schizophrenia patients with histories of cannabis use and/or cannabis-use disorders exhibit superior cognitive function compared with their noncannabis-using counterparts.…”

Clozapine Use and Relapses of Substance Use Disorder Among Patients With Co-occurring Schizophrenia and Substance Use Disorders

“…Comorbid substance use disorder (termed ''substance abuse'' in this report) is common in patients with schizophrenia 1 and is associated with a variety of serious adverse consequences, such as relapse of mental illness, 2,3 hospitalization, 4,5 violence, 6 decreased functioning, 7 homelessness, 8 and serious infectious diseases, such as HIV and hepatitis C. 9,10 Research suggests that integrated dual disorder interventions are effective in reducing substance abuse over several months or years. [11][12][13] There is no clear evidence that first-generation antipsychotic medications, per se, decrease substance abuse, and several investigators have in fact argued that firstgeneration antipsychotic medications may actually precipitate or worsen the abuse of alcohol and other drugs in patients with schizophrenia.…”