Substance Use Among Schizophrenic Outpatients: Prevalence, Course, and Relation to Functional Status

Chouljian, Tandy L.; Shumway, Martha; Balancio, Evelyn; Dwyer, Eleanor; Surber, Robert W.; Jacobs, Marc

doi:10.3109/10401239509149020

Cited by 44 publications

(26 citation statements)

References 17 publications

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“…For this population, substance use disorders are common (1–5) and are associated with multiple adverse outcomes, including treatment dropout (23), recurrent hospitalization (24,25), violence (26), homelessness (27), incarceration (28), relapse (29), and victimization (30), as well as medical problems such as HIV and hepatitis (31). The course of substance use disorders in this population tends to be chronic and relapsing (32,33). Traditional parallel treatment approaches (in separate settings) are ineffective, are fragmented, and result in treatment nonadherence and dropout (34,35).…”

mentioning

confidence: 99%

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Wisdom

Manuel²,

Drake³

2011

Psychiatric Services

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Objective People experiencing a first episode of psychosis frequently have co-occurring substance use disorders, usually involving alcohol and cannabis, which put them at risk for prolonged psychosis, psychotic relapse, and other adverse outcomes. Yet few studies of first-episode psychosis have addressed the course of substance use disorders and the re sponse to specialized substance abuse treatments. Methods The authors searched MEDLINE, PsycINFO, and other medical databases for English-language articles published between 1990 and 2009. Included studies addressed two research questions. First, do some clients become abstinent after a first episode of psychosis without specialized substance abuse treatments? Second, for clients who continue to use substances after a first episode of psychosis, does the addition of specialized substance abuse treatment enhance outcomes? Results Nine studies without specialized substance abuse treatment and five with specialized substance abuse treatment assessed the course of substance use (primarily cannabis and alcohol) after a first episode of psychosis. Many clients (approximately half) became abstinent or significantly reduced their alcohol and drug use after a first episode of psychosis. The few available studies of specialized substance abuse treatments did not find better rates of ab stinence or reduction. Conclusions Experience, education, treatment, or other factors led many clients to curtail their substance use disorders after a first episode of psychosis. Specialized interventions for others need to be developed and tested.

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confidence: 99%

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Wisdom

Manuel²,

Drake³

2011

Psychiatric Services

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“…This is consistent with estimated rates of cocaine dependence in some US studies (Chouljian et al, 1995;, and with the prevalence of stimulant disorders (15.5%) in people aged 15-29 with a first psychosis admission in NSW (Sara et al, 2013). The 12-month prevalence of stimulant abuse or dependence in Australians aged 16-49 is 0.97% (Sara et al, 2011a).…”

Section: Discussionsupporting

confidence: 75%

“…They are more likely to experience relapse or readmission (Hides et al, 2006;Sorbara et al, 2003;Wade et al, 2006a;Strakowski et al, 2007;Linszen et al, 1994) and involuntary hospitalisation (Opsal et al, 2011). They are more likely to have a continuous course of illness (Bertelsen et al, 2009) with lower rates of remission and recovery (Lambert et al, 2005;Petersen et al, 2008) and reduced function in social and other domains (Chouljian et al, 1995;Wade et al, 2007;González-Pinto et al, 2011;Menezes et al, 2009;Faber et al, 2012).…”

Section: Substance Comorbidity In Psychosismentioning

confidence: 99%

“…The SHIP study, however, did not report rates of stimulant abuse or dependence. In three US studies, between 11% and 37% of people with schizophrenia had cocaine use disorders (Chouljian et al, 1995;Gearon and Bellack, 2000;. Lower rates, ranging from 3% to 7%, have been reported in studies from Canada (Margolese et al, 2004) , Western Europe (Modestin et al, 2001) and Scandinavia (Ringen et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Stimulant use disorders and psychosis: prevalence, correlates and impacts

Sara¹

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“…Comorbid substance use disorder is common in patients with schizophrenia (Regier et al 1990) and is associated with a variety of serious adverse consequences such as relapse (Linszen et al 1994), hospitalization (Swofford et al 1996), violence (Cuffel et al 1994), decreased functioning (Chouljian et al 1995), homelessness (Drake et al 1989), and human immunodeficiency virus (HTV) infection (Coumos et al 1991). Recent research suggests that comprehensive dual-disorder treatment programs are effective in reducing substance abuse over several months or years (Drake et al 1998b), but there is no clear evidence that typical antipsychotic medications, per se, decrease substance abuse.…”

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confidence: 99%

The Effects of Clozapine on Alcohol and Drug Use Disorders Among Patients With Schizophrenia

Drake

Xie

McHugo

et al. 2000

Schizophrenia Bulletin

236

123

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Several case studies indicate that clozapine use is associated with reductions in the use of nicotine, alcohol, or illicit drugs. Although not designed to assess clozapine, this study explored a posteriori the effects of clozapine on alcohol and drug use disorders among schizophrenia patients. Among 151 patients with schizophrenia or schizoaffective disorder and co-occurring substance use disorder who were studied in a dual-disorder treatment program, 36 received clozapine during the study for standard clinical indications. All participants were assessed prospectively at baseline and every 6 months over 3 years for psychiatric symptoms and substance use. Alcohol-abusing patients taking clozapine experienced significant reductions in severity of alcohol abuse and days of alcohol use while on clozapine. For example, they averaged 54.1 drinking days during 6-month intervals while off clozapine and 12.5 drinking days while on clozapine. They also improved more than patients who did not receive clozapine. At the end of the study, 79.0 percent of the patients on clozapine were in remission from alcohol use disorder for 6 months or longer, while only 33.7 percent of those not taking clozapine were remitted. Findings related to other drugs in relation to clozapine were also positive but less clear because of the small number of patients with drug use disorders. This study was limited by the naturalistic design and the lack of prospective, standardized measures of clozapine use. The use of clozapine by patients with co-occurring substance disorders deserves further study in randomized clinical trials.

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Substance Use Among Schizophrenic Outpatients: Prevalence, Course, and Relation to Functional Status

Cited by 44 publications

References 17 publications

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Stimulant use disorders and psychosis: prevalence, correlates and impacts

The Effects of Clozapine on Alcohol and Drug Use Disorders Among Patients With Schizophrenia

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