A structured interview and standardized rating scales were used to assess a sample of 194 outpatients with schizophrenia in a regional Australian mental health service for substance use, abuse, and dependence. Case manager assessments and urine drug screens were also used to determine substance use. Additional measurements included demographic information, history of criminal charges, symptom self-reports, personal hopefulness, and social support. The sample was predominantly male and showed relative instability in accommodations, and almost half had a history of criminal offenses, most frequently drug or alcohol related. The 6-month and lifetime prevalence of substance abuse or dependence was 26.8 and 59.8 percent, respectively, with alcohol, cannabis, and amphetamines being the most commonly abused substances. Current users of alcohol comprised 77.3 percent and current users of other nonprescribed substances (excluding tobacco and caffeine) comprised 29.9 percent of the sample. Rates of tobacco and caffeine consumption were high. There was a moderate degree of concordance between case manager determinations of a substance-use problem and research diagnoses. Subjects with current or lifetime diagnoses of substance abuse/dependence were predominantly young, single males with higher rates of criminal charges; however, there was no evidence of increased rates of suicide attempts, hospital admissions, or daily doses of antipsychotic drugs in these groups compared with subjects with no past or current diagnosis of substance abuse or dependence. Subjects with a current diagnosis of substance use were younger at first treatment and currently more symptomatic than those with no past or current substance use diagnosis. The picture emerging from this study replicates the high rate of substance abuse in persons with schizophrenia reported in North American studies but differs from the latter in finding a slightly different pattern of substances abused (i.e., absence of cocaine), reflecting relative differences in the availability of certain drugs.

Objectives To describe the hospital‐treated prevalences for repeat deliberate self‐ poisoning (RDSP) and the demographic characteristics of the RDSP group, and to compare the RDSP and non‐RDSP groups. Design Prospective longitudinal cohort study, with a one‐ to four‐year follow‐up. Setting: The Hunter Area Toxicology Service (HATS), a regional toxicology treatment centre in New South Wales. Subjects 1238 consecutive DSP patients referred to hospital, 1992‐1994, with follow‐up through 1995. Outcome measures Deliberate self‐poisoning (DSP) admissions within one year (RDSP‐1), within six months (RDSP‐6m), and within 28 days (RDSP‐28d) of any other DSP admission by the same patient; length of stay; demographic characteristics; and drugs ingested. Results 175 patients (14.1%) repeated DSP during the study; 165 (13.3%) were classified as RDSP‐1, giving a patient prevalence of hospitalisation in the range of 14.6 to 20.7 per 100000 per year. Fifty‐six RDSP‐28d patients (33.9% of RDSP‐1) accounted for 49.8% of the RDSP‐1 admissions, and 123 RDSP‐6m patients (74.5% of RDSP‐1) accounted for 83.5% of RDSP‐1 admissions. For RDSP‐1, the male:female ratio was 1:1.9, with 35.7% unemployed, 29.1% pensioners and 15.8% married or in de facto relationships. RDSP‐1 patients had a shorter length of stay (3 h), which was not clinically important. RDSP was more likely for the 25‐34 years age group (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.17‐4.29) and the 35‐44 years age group (OR, 2.12; 95% CI, 1.02‐4.39) than the 10‐18 years group, and more likely for women than men (OR, 1.69; 95% CI, 1.17‐2.46). Being married/de facto reduced the risk for repetition (OR, 0.55; 95% CI, 0.31‐0.96) compared with being single. Medications indicated for psychiatric illness were most commonly used for DSP. Conclusions Many patients who repeat DSP do so after a very brief interval and account for a disproportionate number of hospitalisations. Availability of psychiatric medications for DSP patients is a possible area of intervention.

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