Changes in the Pattern of Substance Abuse After the Onset of Psychosis

Abstract

There is a subgroup of non-psychotic addicted patients whose pattern of psychoactive substance abuse is similar to that found in addicted patients suffering from schizophrenia. It may be helpful to systematically identify this subgroup with regard to possible therapeutic implications, particularly with regard to possible pharmacological treatment options.

How is Substance Use Linked to Psychosis? A Study of the Course and Patterns of Substance Dependence in Psychosis

“…Because self-reported data on substance use can provide a reliable and valid basis for prevalence estimation (6), we believe that our study gives accurate estimations on the prevalence of alcohol and cannabis dependence, as these self-reports have also been corroborated by interviews with the relatives. Our study, in line with other studies (44, 45, 46), found a higher amount of substances (excluding tobacco) being used by the schizophrenia and bipolar groups when compared to the pure substance dependence group. It is possible that people with psychosis are vulnerable to using more substances, either to reduce their symptoms or to heighten the reduced euphoric feeling (24, 47).…”

Clinical outcomes for psychotic and co-morbid patients admitted to acute psychiatric wards in four European centres – follow-up to 6 months

“…These range from individual case studies (Chaudry, Moss, Bashir, & Suliman, 1991) to the association between specific drugs (Arendt, Rosenberg, Foldager, Perto, & Munk-Jørgensen, 2005;Degenhardt et al, 2007;McGuire et al, 1994;Zammit et al, 2008) looking for causal links (Ferdinand et al, 2005;Fergusson, Horwood, & Ridder, 2005), or substance use patterns in psychotic patients (Verdoux, Tournier, & Cougnard, 2005;Virgo, Bennett, Higgins, Bennett, & Thomas, 2001). Much focus on the subject of co-morbidity has been on connections between drug use and psychosis; at predictors and patterns of drug use and patterns of psychopathology in co-morbid versus non-co-morbid patients (Dalmau, Bergman, & Brismar, 1999;Grace, Shenfield, & Tennant, 2000;Kaiser, Lo¨hrer, Morgan, & Hambrecht, 2005;Pencer & Addington, 2003;Sevy et al, 2001). Where patients are co-morbid the evidence suggests there is a poorer prognosis (Grech, Van Os, Jones, Lewis, & Murray, 2005).…”

Drugs and Psychosis Project: A multi‐centre European study on comorbidity

“…Comorbidity of drug use and psychiatric disorders is a well‐documented and widespread problem [8–12]. In spite of this, there are some problems both in the methodological issues arising in the study of this difficult population [8,13] and in the interpretation of the available evidence.…”

“…[11,15]). The approach to patient and control groups differs between centres, with some comparing comorbid patients with schizophrenic patients, or those with other forms of psychosis [14,10], and others comparing comorbid patients with non‐psychotic drug users [9].…”

“…High rates of substance abuse in general are reported in psychotic patients [15,19]. The use and abuse of substances including alcohol and nicotine have been associated with specific pathology [9,20], and higher morbidity and mortality rates [21].…”