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Psychosis and substance abuse: cause, effect or coincidence?
S M Lawrie1, J K Hutchison, S R Sweeney
1University Department of Psychiatry, Royal Edinburgh Hospital and Edinburgh University Medical School.
Scottish Medical Journal
|December 1, 1995
Summary
Substance abuse is common in patients with psychosis, especially schizophrenia. Healthcare providers should screen all psychotic patients for substance use and offer interventions to reduce consumption.
Area of Science:
- Psychiatry
- Addiction Medicine
- Clinical Psychology
Background:
- The link between substance abuse and major psychiatric disorders is recognized.
- Previous research primarily focused on schizophrenia in the USA.
Purpose of the Study:
- To investigate the prevalence of substance abuse in patients with functional psychoses.
- To compare substance abuse patterns between schizophrenia and affective disorder patients.
Main Methods:
- Survey of 38 consecutively admitted patients with DSM-III-R functional psychoses.
- Semi-structured substance abuse interview and urine drug metabolite screening.
Main Results:
- Cigarette smoking (63%) and illicit drug use (26%) were higher than general population norms.
- Schizophrenia patients were more likely to smoke cigarettes (OR 8.4) and showed higher illicit drug/alcohol consumption than affective disorder patients.
- Illicit drug users had more forensic histories and less higher education.
Conclusions:
- Substance abuse is prevalent in psychotic patients, particularly those with schizophrenia.
- A detailed drug history and therapeutic interventions for substance use are recommended for all psychotic patients.