Prevalence of comorbid substance use in schizophrenia spectrum disorders in community and clinical settings, 1990–2017: Systematic review and meta-analysis

Hunt, Glenn E.; Large, Matthew; Cleary, Michelle; Lai, Harry Man Xiong; Saunders, John B.

doi:10.1016/j.drugalcdep.2018.07.011

Cited by 354 publications

(258 citation statements)

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“…In both samples, substance use was more prevalent in young males and the most socially deprived. The higher prevalence of both SUD diagnosis and substance use found among inpatients aligns with previous studies [8,14], and suggests that in inpatient treatment, there is a different patient case mix with relatively higher rates of severe mental illness, such as schizophrenia and major depression, which are typically associated with higher rates of co-occurring SUD [3,8,4].…”

Section: Discussionsupporting

confidence: 82%

“…Most previous studies on substance use among psychiatric patients were carried out among patients within specific diagnostic categories, such as schizophrenia, bipolar disorders and major depression [6][7][8][9][10]4]. A strong association between severe mental disorders and SUD has been shown both among inpatients and outpatients [8], as well as among patients in acute departments [11,12]. The most frequently reported substances used among patients with severe mental disorders were alcohol, cannabis, sedatives and stimulants [3,11,12].…”

Section: Introductionmentioning

confidence: 99%

“…The most frequently reported substances used among patients with severe mental disorders were alcohol, cannabis, sedatives and stimulants [3,11,12]. In some studies, alcohol was found to be the most prevalent drug used across all psychiatric disorders [3], whereas other studies estimated the use of illicit substances to be more common than alcohol use among those with severe mental illness [8,4]. While many studies have investigated SUD among patients with severe mental illness, substance use in patients with less severe mental disorders, such as anxiety and affective disorders [13], has received less attention.…”

Section: Introductionmentioning

confidence: 99%

“…Despite previous research among psychiatric patients used different samples and different methods to identify substance use, and thus reported varying SUD prevalence rates, the findings regarding the characteristics of patients with substance use problems are consistent. Previous studies have shown that co-occurring mental disorders and SUD are associated with being male [3,8,10,14], younger and single [14,16]. Moreover, research has demonstrated that psychiatric patients with SUD have less educational attainment [3,14,17] and generally more adverse socio-economic characteristics [15].…”

Section: Introductionmentioning

confidence: 99%

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Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Andersson

Lilleeng

Ruud

et al. 2020

Preprint

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Purpose: The aim of this study was to investigate the clinical and demographic variation in the prevalence of substance use among the general psychiatric population in Norway.Methods: A national census in psychiatric institutions and outpatient clinics was conducted. Data were returned for 2,358 inpatients (response rate, 65%) and 23,167 outpatients (response rate, 60%). Substance use was measured based on substance use disorder diagnosis or reported substance use in the last four weeks (alcohol 2–4 days a week or illicit drug use). Regression analyses controlling for demographic and socio-demographic characteristics were carried out.Results: Substance use was identified in 32.4% of inpatients and 13.9% of outpatients. The most frequently reported substances used were alcohol, sedatives and cannabis. Among inpatients, the prevalence of substance use was highest in patients with schizophrenia, personality disorders and anxiety disorders. Among outpatients, the prevalence was highest in patients with schizophrenia and other psychoses. Inpatients with anxiety disorders and outpatients with schizophrenia and other psychoses had a significantly higher risk of substance use than other patients. In both samples, the prevalence of substance use was higher among males, 24–29-year-olds and the most socially deprived.Conclusions: This study provides further knowledge about patients at risk for co-morbid substance abuse and poor treatment outcomes. Clinicians may consider targeting patients with severe mental illness, young males and those who are socially deprived in efforts to prevent emerging substance abuse and improve outcomes.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Andersson

Lilleeng

Ruud

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Drug abuse and addiction (used interchangeably) is very common in patients with schizophrenia, occurring up to five times more frequently than in the general population, and affecting nearly 50% of patients (excluding nicotine dependence, which affects nearly 90% of patients with schizophrenia) [4,5]. For example, cannabis abuse occurs in 50% of patients with schizophrenia, compared to 1% of the general population, nicotine abuse occurs in 29% of patients, compared to 13% of the general population, and alcohol abuse occurs in 43-65% of patients, compared to 5% of the general population [5].…”

Section: Introductionmentioning

confidence: 99%

Schizophrenia and drug addiction comorbidity: recent advances in our understanding of behavioural susceptibility and neural mechanisms

Menne

Chesworth

2020

Neuroanatomy and Behaviour

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Schizophrenia is a severe psychiatric disorder which is worsened substantially by substance abuse/addiction. Substance abuse affects nearly 50% of individuals with schizophrenia, extends across several drug classes (e.g. nicotine, cannabinoids, ethanol, psychostimulants) and worsens overall functioning of patients. Prominent theories explaining schizophrenia and addiction comorbidity include the primary addiction hypothesis (i.e. schizophrenia susceptibility primes drug reward circuits, increasing drug addiction risk following drug exposure), the two-hit hypothesis (i.e. drug abuse and other genetic and/or environmental risk factors contribute to schizophrenia development) and the self-medication hypothesis (i.e. drug use alleviates schizophrenia symptoms). Animal models can be used to evaluate the utility and validity of these theories. Since this literature was last reviewed by Ng and colleagues in 2013 [Neurosci Biobehav Rev, 37(5)], significant advances have been made to our understanding of schizophrenia and substance abuse comorbidity. Here we review advances in the field since 2013, focussing on two key questions: 1) Does schizophrenia susceptibility increase susceptibility to drug addiction (assessing the primary addiction hypothesis), and 2) Do abused drugs exacerbate or ameliorate schizophrenia symptoms (assessing the two-hit hypothesis and the self-medication hypothesis). We addressed these questions using data from several schizophrenia preclinical models (e.g. genetic, lesion, neurodevelopmental, pharmacological) across drug classes (e.g. nicotine, cannabinoids, ethanol, psychostimulants). We conclude that addiction-like behaviour is present in several preclinical schizophrenia models, and drugs of abuse can exacerbate but also ameliorate schizophrenia-relevant behaviours. These behavioural changes are associated with altered receptor system function (e.g. dopaminergic, glutamatergic, GABAergic) critically implicated in schizophrenia and addiction pathology.

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Disruptions in Care for Medicare Beneficiaries With Severe Mental Illness During the COVID-19 Pandemic

et al. 2022

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Key Points Question Was the COVID-19 pandemic associated with changes in mental health–related utilization for individuals with severe mental illness in the United States? Findings In this cohort study of more than 650 000 Medicare beneficiaries with schizophrenia or bipolar I disorders, there were statistically significant decreases in mental health–related outpatient, emergency department, and inpatient use as well as medication fills, particularly early in the pandemic, despite widespread use of telemedicine. Statistically significant differentially greater decreases in outpatient utilization were observed among individuals who were Black, had dual Medicare-Medicaid eligibility, or had disability. Meaning In this study, individuals with severe mental illness experienced substantial disruptions in care during the pandemic, and these disruptions were greater among disadvantaged populations.

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Prevalence of comorbid substance use in schizophrenia spectrum disorders in community and clinical settings, 1990–2017: Systematic review and meta-analysis

Cited by 354 publications

References 214 publications

Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Schizophrenia and drug addiction comorbidity: recent advances in our understanding of behavioural susceptibility and neural mechanisms

Disruptions in Care for Medicare Beneficiaries With Severe Mental Illness During the COVID-19 Pandemic

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