Prevalence of alcohol use disorders in schizophrenia – a systematic review and meta‐analysis

Koskinen, Jukka; Löhönen, Johanna; Koponen, Hannu; Isohanni, Matti; Miettunen, Jouko

doi:10.1111/j.1600-0447.2009.01385.x

Cited by 114 publications

(87 citation statements)

References 79 publications

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“…A substantial proportion of people with schizophrenia misuse alcohol and other drugs (Green et al, 2005;Swartz et al, 2006a;Koskinen et al, 2009;Koskinen et al, 2010), though this varies between different settings and geographical areas (Carrà et al, 2012). However, this body of research has been troubled by methodological issues.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Carrà

Johnson

Crocamo

et al. 2016

Psychiatry Research

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Little is known about the correlates of comorbid drug and alcohol dependence in people with schizophrenia outside the USA. We tested hypotheses that dependence on alcohol or drugs would be associated with more severe symptoms, and poorer psychosocial functioning and quality of life.The EuroSC Cohort study (N=1,204), based in France, Germany and the UK, used semi-structured clinical interviews for diagnoses, and standardized tools to assess correlates. We used mixed models to compare outcomes between past-year comorbid dependence on alcohol or drugs, controlling for covariates and modelling both subject and country level effects. Participants dependent on alcohol or drugs had fewer negative symptoms on PANSS than their non-dependent counterparts. However, those dependent on alcohol scored higher on PANSS general psychopathology than those who were not dependent, or dependent only on drugs. People suffering from schizophrenia dependent on drugs had poorer quality of life, more extrapyramidal side effects, and scored worse on GAF than those without dependence. People with alcohol dependence reported more reasons for noncompliance with medication, and poorer functioning on Global Assessment of Functioning (GAF), though not on Global Assessment of Relational Functioning (GARF). In people with schizophrenia, comorbid dependence on alcohol or drugs is associated with impaired clinical and psychosocial adjustment, and poorer quality of life.

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Section: Introductionmentioning

confidence: 99%

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Carrà

Johnson

Crocamo

et al. 2016

Psychiatry Research

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“…Alcohol use disorders (AUD) are common in schizophrenia, with one Australian study finding as many as 57% of inpatients and 46% of outpatients meeting the criteria for the diagnosis of an AUD (Dawe et al, 2000). The prevalence of comorbid lifetime AUD worldwide is 20.6% (Koskinen et al, 2009). Alcohol abuse contributes to violence, imprisonment and homelessness of people with schizophrenia and is also associated with a worse outcome through non-adherence to treatment and poor physical health.…”

Section: Psychosis and Substance Usementioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

665

672

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Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods:The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RANZCP GuidelinesGalletly et al. 411 Australian & New Zealand Journal of Psychiatry, 50(5)Results: The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. Conclusions:This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.

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“…A meta-analysis reported median current alcohol use disorder rates at 9.4% and median lifetime rates of 20.6% (Koskinen et al, 2009). This is an additional risk factor for CVD and diabetes.…”

Section: Misuse Of Alcoholmentioning

confidence: 99%

BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment

et al. 2016

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Excess deaths from cardiovascular disease are a major contributor to the significant reduction in life expectancy experienced by people with schizophrenia. Important risk factors in this are smoking, alcohol misuse, excessive weight gain and diabetes. Weight gain also reinforces service users' negative views of themselves and is a factor in poor adherence with treatment. Monitoring of relevant physical health risk factors is frequently inadequate, as is provision of interventions to modify these. These guidelines review issues surrounding monitoring of physical health risk factors and make recommendations about an appropriate approach. Overweight and obesity, partly driven by antipsychotic drug treatment, are important factors contributing to the development of diabetes and cardiovascular disease in people with schizophrenia. There have been clinical trials of many interventions for people experiencing weight gain when taking antipsychotic medications but there is a lack of clear consensus regarding which may be appropriate in usual clinical practice. These guidelines review these trials and make recommendations regarding appropriate interventions. Interventions for smoking and alcohol misuse are reviewed, but more briefly as these are similar to those recommended for the general population. The management of impaired fasting glycaemia and impaired glucose tolerance ('pre-diabetes'), diabetes and other cardiovascular risks, such as dyslipidaemia, are also reviewed with respect to other currently available guidelines.These guidelines were compiled following a consensus meeting of experts involved in various aspects of these problems. They reviewed key areas of evidence and their clinical implications. Wider issues relating to primary care/secondary care interfaces are discussed but cannot be resolved within guidelines such as these.

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Prevalence of alcohol use disorders in schizophrenia – a systematic review and meta‐analysis

Abstract: Approximately every fifth patient with schizophrenia had lifetime AUD diagnosis. When contrasted with the most recent review, there might be a descending trend in AUD prevalence in patients with schizophrenia.

Cited by 114 publications

References 79 publications

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Psychosocial functioning, quality of life and clinical correlates of comorbid alcohol and drug dependence syndromes in people with schizophrenia across Europe

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment

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