[Comorbidity of alcohol-substance use disorders in schizophrenia: a review]

There is a high alcohol/substance use disorder comorbidity rate in schizophrenia. This article reviews the prevalence of comorbid alcohol-substance use disorders in schizophrenia, methodological problems while examining this topic, etiological models, the impact of alcohol-substance use disorders on course and outcome of schizophrenia and treatment of these comorbid conditions. The literature search was conducted through the Medline records of the National Library of Medicine. The etiology of high prevalence rate of alcohol-substance use disorders in schizophrenia is unclear. There is support for the supersensitivity model which posits that biological vulnerability of psychiatric disorders results in sensitivity to small amounts of alcohol and drugs, leading to substance use disorders. There is minimal support for the self-medication model, but the accumulation of other risk factors, may increase the risk of substance use disorder. While planning the risk prevention, care and treatment of schizophrenic patients, alcohol-substance abuse must also be evaluated. Particularly young male patients, patients who have antisocial personality properties and depressive symptoms must be taken as a group with risk and alcohol-substance use must be evaluated carefully in this population. Relapses, violence and suicide risks must be taken in to account while treatment of these comorbid patients. They must be taken as a different group regarding the treatment and some special interventions must be taken with these patients.