[CO-OCCURRING SCHIZOPHRENIA AND SUBSTANCE USE DISORDER: ETIOLOGICAL THEORIES AND CHALLENGES IN ISRAEL]

A sizeable number of patients suffering from psychotic disorders, particularly schizophrenia, are also diagnosed with substance use disorder (SUD). These dual diagnosis (DD) patients are considered very difficult to treat and differ in some of their characteristics from patients with schizophrenia or SUD exclusively. They have a worse prognosis and require more complex treatment which needs to be integrated for both of the disorders. In Israel there is a lack of training, professionals and institutions specializing in treatment for this population. Consequently, many DD patients are left without care in the community and as a result, their relapses and hospitalizations are more frequent. In addition, many of the patients are not accepted to the existing institutions due to the requirement that the patient has to express clear motivation to stop his substance abuse. In this article we will review etiological theories of the comorbidity between chronic psychotic disorders and SUD. These theories explain the unique difficulty of DD patients to develop motivation to quit or diminish substance abuse. The data presented here sheds light on the gap between the needs of these patients and the current situation in Israel, urging the need to change the approach and adapt treatments for this unique population.