Impact of Substance Use Disorder on Presentation and Short-Term Course of Schizophrenia

Abstract

The aim of the present study was to compare a cohort of schizophrenia patients with substance use disorder (SUD) with a similar cohort of schizophrenia patients without SUD with regard to sociodemographic variables, clinical variables, psychopathology, anxiety symptoms, depressive symptoms, treatment outcome, and side effect profile of drugs. A total of 143 consecutive inpatients with ICD-10 DCR diagnosis of schizophrenia were included after obtaining informed consent. Patients were evaluated by a semistructured data sheet and Maudsley Addiction Profile. They were then rated by Positive and Negative Symptoms Scale, Calgary Depression Scale, Hamilton Anxiety Rating Scale, and Brief Psychiatric Rating Scale at presentation, three weeks, and six weeks. At three weeks and six weeks, they were also evaluated by UKU Side Effect Rating Scale. Substance abuse was detected in 63.6% schizophrenia patients. Nicotine was the commonest substance followed by cannabis and alcohol. Substance users had longer untreated illness and more depressive symptoms at presentation and six-week follow-up. Dual diagnosis patients had difficulty in abstraction at three and six weeks but not at presentation. Schizophrenia patients with SUD had more depressive symptoms. SUD appeared to mask abstraction difficulties at presentation. Schizophrenia patients with SUD should be carefully assessed for presence of depression.

Alcohol Use Disorder and Its Associate Factors Relating to Patients with Severe Mental Disorders Attending Psychiatric Follow-Ups in Northwest Ethiopia

“…On the other hand, the prevalence of the current study was higher than those of studies done in Addis Ababa, Ethiopia, 20 Nigeria, 12 Sri Lanka, 10 Singapore 6 and India. 21 The discrepancy might be due to most of the indicated studies were measured by using different tools like ASSIST. And the participants were patients with bipolar disorders, and depression and schizophrenia in the Addis Ababa’s and Singapore’s studies, respectively.…”

“…Again, it can result in non-adherence to treatments, relapse of psychiatric disorders, an increase in the cost of health care, and the reduction of the quality of life among patients with severe mental disorders. 21 , 22 , 32 Researchers reported that younger age, 15 , 20 male sex, 10 , 18 being unmarried, 13 low educational level, 10 , 20 unemployment, 10 , 33 longer duration of illness, 30 , 34 early age of onset of illness, 34 , 35 and having schizophrenia and/bipolar disorders 12 , 15 are the main factors that influence individuals with severe mental disorders to have AUD. Having poor social support, 10 , 11 high perceived stress, 11 use of other psychoactive substances like tobacco smoking, 6 , 12 , 19 and family history of alcohol and other substance use disorders 16 , 36 are also important contributing factors to AUD among patients with severe mental disorders.…”

“…Co-morbid AUD adversely affecting both the course and treatment outcomes of mental disorders. [21][22][23][24] It can increase the incidence of physical conditions [25][26][27][28] such as hypertension, cardiovascular disease, HIV/AIDS infection, cirrhosis and accidental injuries, and behavioral disorders [29][30][31] like suicidality, violent/aggressiveness and social relationship problems. Again, it can result in non-adherence to treatments, relapse of psychiatric disorders, an increase in the cost of health care, and the reduction of the quality of life among patients with severe mental disorders.…”

Khat Chewing and Relapse in Peoples With Serious Mental Illness At Amanuel Mental Specialized Hospital: Comparative Study

“…Different studies indicate that SMI patients using illicit drug exhibit poorer outcomes in a variety of domains: symptom severity, psychiatric relapse, hospitalization, suicide (40) (41), incarceration, violence and victimization, physical health problems, homelessness (42), extended hospitalization (43), increased healthcare costs, reduced compliance with medications, increase treatment resistance (44), increased depression symptoms (45) and suicide ideation, as well as mania and bipolar disorder(46). The substances mostly studied are cannabis, alcohol and amphetamine but there is no large study on khat effect in people with SMI, but case reports (47) and qualitative study(48) noted that patients with serious mental illness who used khat had their illness exacerbated by the use of it.…”

Medication Adherence among Mentally Ill Patients with comorbid- Substance Use Disorder

“…The term originated from the USA in the 1980s and has been adopted in the UK more recently. Worsening psychiatri c symptoms , more frequent re hospitalisation , poor physical health, poor medicine adherence and others 13,14 . Studies have documented that treatment compliance can be affected by the concurrent presenc e of substanc e abuse.…”