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Substance Use Disorder Comorbidity in Schizophrenia

Year 2013, Volume: 5 Issue: 3, 260 - 275, 01.09.2013
https://doi.org/10.5455/cap.20130517

Abstract

Use of alcohol and other substances are commonly observed among patients with a diagnosis of schizophrenia. Despite this common comorbidity, there have been very few studies which do not take alcohol/substance use as an exclusion criterion. Thus we have very limited data on this specific area. A number of theories have been developed to explain these high comorbidity rates. Typical antipsychotic medications decreases alcohol or substance use in general, but this is valid only for a limited extend in patients with schizophrenia. On the other hand atypical antipsychotics, particularly clozapine plays an active role in that respect. Recently, we can see lots of new adjunctive medications formulated for the treatment of alcoholism, but only one of them (naltrexone) has thus far been carefully studied and tested in relation with these patients with schizophrenia. It is not reasonable to consider that pharmacological approaches may alone provide us with optimal results in these patients. Ultimately, it should be intended to have a well-balanced psychosocial treatment programs including also psychotherapetical inputs.

References

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  • Hwang MY, Bermanzohn PC. Management of Schizophrenia with Comorbid Conditions. Washington DC, American Psychiatric Publishing, 2002.
  • Ziedonis DM, Fisher W. Assessment and treatment of comorbid substance abuse in individuals with schizophrenia. Psychiatr Ann 1994; 24:477-483.
  • Jimenez-Castro L, Hare E. Substance use disorder comorbidity with schizophrenia in families of Mexican and Central American ancestry. Schizopr Res 2010; 120:87-94.
  • Evren C, Evren C. Şizofreni ve alkol madde kullanım bozuklukları ek tanısı: bir gözden geçirme. Turk Psikiyatri Derg 2003; 14:213-224.
  • Verma SK, Subramaniam M, Chong S, Kua EH. Substance abuse in schizophrenia: A Singapore perspective. Soc Psychiatry Psychiatr Epidemiol 2002; 37:326-328.
  • Reiger DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL et al. Comorbidty of mental disorders with alcohol and other drug abuse. JAMA 1990; 264:2511-2518.
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  • Hambrecht M, Hafner H. Cannabis, vulnerability, and the onset of schizophrenia: an epidemiological perspective. Aust NZ J Psychiatry 2000; 34:468-475.
  • Aras Hİ. Erkek şizofreni hastalarında alkol ve/veya madde kullanımının yaşam kalitesine etkisi (Uzmanlık tezi). İstanbul, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, 20 Depçe AA. Erkek şizofreni hastalarında bakım veren yükü açısından alkol ve madde kullanımı varlığının etkisi (Uzmanlık tezi). İstanbul, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, 2010.
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  • Mueser KT, Yarnold PR, Levinson DF, Singh H, Bellack AS, Kee K et al. Prevalence of substance abuse in schizophrenia: demographic and clinical correlates. Schizophr Bull 1990; 16:31-56.
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  • LeDuc PA, Mittleman G. Schizophrenia and psychostimulant abuse: a review and reanalysis of clinical evidence. Psychopharmacology 1995; 121:407-427.
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  • Brunette M, Mueser KT, Drake RE. Relationships between symptoms of schizophrenia and substance abuse. J Nerv Ment Dis 1997; 185:13-20.
  • Patkar AA, Alexander RC, Lundy A, Certa KM. Changing patterns of illicit substance use among schizophrenic patients:1984-1996. Am J Addict 1999; 8:65-71.
  • Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL et al. Comorbidity of mental disorders with alcohol and other drug abuse. JAMA 1990; 264:2511-2518.
  • Dixon L. Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes. Schizophr Res 1999; 35:93-100.
  • Krystal JH, D’Souza DC, Madonick S, Petrakis IL. Toward a rational pharmacotherapy ofcomorbid substance abuse in schizophrenic patients. Schizophr Res 1999; 35:35-49
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  • Mueser KT, Drake RE. Wallach MA. Dual diagnosis: a review of etiological theories. Addict Behav 1998; 23:717-734
  • Addington J, Addington D. Effect of substance misuse in early psychosis. Br J Psychiatry 1998; 172:134-136.
  • Schuckit M. Drug and Alcohol Abuse. A Clinical Guide to Diagnosis and Treatment. New York, Kluwer Academic/Plenum, 2000
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  • Brunette MF, Drake RE, Lynde D. Toolkit for Integrated Dual Diagnosis Treatment. Substance Abuse and Mental Health Services Administration, Rockville, 2002. Hatice İmer Aras, Uzm. Dr., Iğdır Devlet Hastanesi, Iğdır. Yazışma Adresi/Correspondence: Hatice İmer Aras, Iğdır Devlet Hastanesi, Iğdır, Turkey. E-mail: ipekimer@hotmail.com Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemişlerdir. The authors reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol5/no3/ Çevrimiçi yayım / Published online 11 Ağustos/August 11, 2013; doi:10.5455/cap.20130517

Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı

Year 2013, Volume: 5 Issue: 3, 260 - 275, 01.09.2013
https://doi.org/10.5455/cap.20130517

Abstract

Şizofreni tanısı alan hastalarda alkol ve madde kullanımı yaygındır. Şizofrenide alkol madde kullanım bozuklukları sıklığı yüksek olmasına rağmen yapılan tüm çalışmalarda madde kullanım ektanısının dışlanması bu alandaki verilerin çok kısıtlı olmasına yol açmıştır. Yüksek eştanılılığın açıklanmasında pek çok teori öne atılmıştır. Tipik antipsikotik ilaçların şizofreni tanılı hastalarda alkol ve madde kullanımına etkileri sınırlıdır. Atipik antipsikotik ilaçların özellikle klozapin kullanımının etkinliği gösterilmiştir. Literatüre baktığımızda, alkol kötüye kullanımı tedavisinde pek çok yeni ajan ortaya çıkmışsa da, sadece bir tanesinin (naltrekson) şizofreni tanılı hastalarda kullanımına dair çalışmalar mevcuttur. Bu hasta populasyonunda, farmakolojik yaklaşımların tek başına en uygun fayda getireceğini düşünmek doğru bir yaklaşım olmaz. Psikoterapinin de içerisinde bulunduğu, iyi koordine edilmiş bir tedavi planı mutlak hedef olmalıdır.

References

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  • Karakuş G, Evlice YE, Tamam L. Psikiyatri kliniğinde yatan hastalarda alkol ve madde kullanım bozukluğu sıklığı. Çukurova Üniversitesi Tıp Fakültesi Dergisi 2012; 37:37-48.
  • Hwang MY, Bermanzohn PC. Management of Schizophrenia with Comorbid Conditions. Washington DC, American Psychiatric Publishing, 2002.
  • Ziedonis DM, Fisher W. Assessment and treatment of comorbid substance abuse in individuals with schizophrenia. Psychiatr Ann 1994; 24:477-483.
  • Jimenez-Castro L, Hare E. Substance use disorder comorbidity with schizophrenia in families of Mexican and Central American ancestry. Schizopr Res 2010; 120:87-94.
  • Evren C, Evren C. Şizofreni ve alkol madde kullanım bozuklukları ek tanısı: bir gözden geçirme. Turk Psikiyatri Derg 2003; 14:213-224.
  • Verma SK, Subramaniam M, Chong S, Kua EH. Substance abuse in schizophrenia: A Singapore perspective. Soc Psychiatry Psychiatr Epidemiol 2002; 37:326-328.
  • Reiger DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL et al. Comorbidty of mental disorders with alcohol and other drug abuse. JAMA 1990; 264:2511-2518.
  • Addington J, Addington D. Impact of an early psychosis program on substance use. Psychiatr Rehabil J 2001; 25:60-67.
  • Hambrecht M, Hafner H. Cannabis, vulnerability, and the onset of schizophrenia: an epidemiological perspective. Aust NZ J Psychiatry 2000; 34:468-475.
  • Aras Hİ. Erkek şizofreni hastalarında alkol ve/veya madde kullanımının yaşam kalitesine etkisi (Uzmanlık tezi). İstanbul, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, 20 Depçe AA. Erkek şizofreni hastalarında bakım veren yükü açısından alkol ve madde kullanımı varlığının etkisi (Uzmanlık tezi). İstanbul, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, 2010.
  • Drake RE, Mueser KT, Brunette MF. A review of treatments for people with severe mental illnesses and co-occuring substance use disorders. Psychiatry Rehabil J 2004; 27:360-374.
  • Mueser KT, Yarnold PR, Levinson DF, Singh H, Bellack AS, Kee K et al. Prevalence of substance abuse in schizophrenia: demographic and clinical correlates. Schizophr Bull 1990; 16:31-56.
  • Mueser KT, Yarnold PR, Rosenberg SD. Substance use disorder in hospitalized severely mentally ill psychiatric patients: prevalence, correlates, and subgroups. Schizophrenia Bull 2000; 26:179-192.
  • Cantor-Graae E, Nordstrom LG, McNeil TF. Substance abuse in schizophrenia:a review of literature and a study of correlates in Sweden. Schizophr Res 2001; 48:69
  • Schneier FR, Siris SG. A review of psychoactive substance use and abuse in schizophrenia. Patterns of drug choice. J Nerv Ment Dis 1987; 175:641-652.
  • LeDuc PA, Mittleman G. Schizophrenia and psychostimulant abuse: a review and reanalysis of clinical evidence. Psychopharmacology 1995; 121:407-427.
  • DeLeon J, Diaz FJ. A meta-analysis of world-wide studies demonstrating an association between schizophrenia and tobacco smoking behaviors. Schizophr Res 2005; 76: 135-1
  • Akvardar Y, Tumuklu M, Akdede BB. Substance use among patients with schizophrenia in a university hospital. Bull Clin Psychopharmacol 2004; 14:191-197.
  • Noordsy DL, Drake RE, Teague GB, Osher FC, Hurlbut SC, Beaudett MS et al. Subjective experiences related to alcohol use among schizophrenics. J Nerv Ment Dis 1991; 179:410-414.
  • Smith WA. Profile of Health and Disease in America: Mental Illness and Substance Abuse. New York, 1989.
  • Mueser KT, Yarnold PR, Bellack AS. Diagnostic and demographic correlates of substance abuse in schizophrenia and major affective disorder. Acta Psychiatr Scand 1992; 85:48-55.
  • Dervaux A, Laqueille X. Cannabis and schizophrenia: demographic and clinical correlates. Encephale. 2003; 29:11-17.
  • Myers JK, Weissman MM, Tischler GL, Holzer CE, Leaf PJ, Orvaschel H et al. Sixmonth prevalence of psychiatric disorders in three communities. Arch Gen Psychiatry 1984; 41:959-967.
  • Dalack GW, Healy DJ, Meador-Woodruff JH. Nicotine dependence in schizophrenia: clinical phenomena and laboratory findings. Am J Psychiatry 1998; 155:1490150
  • Khantzian EJ. The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harv Rev Psychiatry 1990; 4:133-134.
  • Brunette M, Mueser KT, Drake RE. Relationships between symptoms of schizophrenia and substance abuse. J Nerv Ment Dis 1997; 185:13-20.
  • Patkar AA, Alexander RC, Lundy A, Certa KM. Changing patterns of illicit substance use among schizophrenic patients:1984-1996. Am J Addict 1999; 8:65-71.
  • Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL et al. Comorbidity of mental disorders with alcohol and other drug abuse. JAMA 1990; 264:2511-2518.
  • Dixon L. Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes. Schizophr Res 1999; 35:93-100.
  • Krystal JH, D’Souza DC, Madonick S, Petrakis IL. Toward a rational pharmacotherapy ofcomorbid substance abuse in schizophrenic patients. Schizophr Res 1999; 35:35-49
  • Fadda F, Mosca E, Colombo G, Gessa GL. Effects of spontaneous ingestion of ethanol on brain dopamin metabolism. Life Sci 1989; 44:281-287.
  • Mueser KT, Drake RE. Wallach MA. Dual diagnosis: a review of etiological theories. Addict Behav 1998; 23:717-734
  • Addington J, Addington D. Effect of substance misuse in early psychosis. Br J Psychiatry 1998; 172:134-136.
  • Schuckit M. Drug and Alcohol Abuse. A Clinical Guide to Diagnosis and Treatment. New York, Kluwer Academic/Plenum, 2000
  • Herning RI, Glove BJ, Koeppl B, Weddington W, Jaffe JH. Cognitive deficits in abstaining cocaine abusers. National Institute on Drug Abuse Research Monograph No.101: 167-178. Washington, 1990.
  • Brady K, Anton R, Ballenger JC. Cocaine abuse among schizophrenic patients. Am J Psychiatry 1997; 154:1538-1543.
  • Schmidt LM, Hesse M. The impact of substance use disorders on the course of schizophrenia-A 15 year follow-up study Dual diagnosis over 15 years. Schizophr Res 2011; 130:228-33.
  • Cuffel BJ, Shumway M, Chouljian TL, MacDonald T. A longitudinal study of substance use and community violence in schizophrenia. J Nerv Ment Dis 1994; 182:704-708.
  • Swanson J, Holzer C, Ganju V, Jono R. Violence and psychiatric disorder in the community: Evidence from the Epidemiologic Catchment Area surveys. Hosp Community Psychiatry 1990; 41:761-770.
  • Rasanen P, Tiihonen J, Isohanni. Schizophrenia, alcohol abuse, and violent behavior:a 26-year followup study of an unselected birth cohort. Schizoph Bull 1998; 24:437-441.
  • Brunette MF, Mueser KT, Xie H, Drake RE. Relationships between symptoms of schizophrenia and substance abuse. J Nerv Ment Dis 1997; 185:13–20.
  • Hambrecht M, Hafner H. Substance abuse and the onset of schizophrenia. Biol Psychiatry1996; 1:1155-1163.
  • Seibyl JP, Satel SL, Anthony D, Southwick SM, Krystal JH, Charney DS. Effects of cocaine on hospital course in schizophrenia. J Nerv Ment Dis1993; 181:31-37.
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Details

Primary Language Turkish
Journal Section Review
Authors

Hatice İmer Aras This is me

Publication Date September 1, 2013
Published in Issue Year 2013 Volume: 5 Issue: 3

Cite

AMA Aras Hİ. Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. September 2013;5(3):260-275. doi:10.5455/cap.20130517

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