Suspiciousness and alcohol use disorders in schizophrenia

Problems with alcohol are a common and important comorbidity in patients with schizophrenia. Previous studies showed an association between depression and alcohol abuse in patients with schizophrenia. Suspiciousness has been shown to be associated with depression. In a population-based study, the authors tested the hypothesis that suspiciousness is associated with alcohol problems in patients with schizophrenia. Data came from the first wave of the five-site Epidemiological Catchment Area study. Baseline clinical and demographic data were analyzed to assess associations between symptoms and an alcohol abuse or dependence diagnosis in patients with a Diagnostic Interview Schedule (DIS) diagnosis of schizophrenia. Suspiciousness was associated with an alcohol dependence or abuse diagnosis in male DIS-DSM-III schizophrenia patients, after accounting for demographic and other clinical variables. There were no associations between alcohol problems and either conceptual disorganization or hallucinations and nonsuspicious delusions. Suspiciousness appears to be associated with alcohol abuse and dependence in men with schizophrenia. Further studies should attempt to investigate the temporal relationship between suspiciousness and alcohol problems. Interventions that address suspiciousness may decrease the risk of alcohol problems in this population.