Yıl 2013, Cilt 5 , Sayı 3, Sayfalar 260 - 275 2013-09-01

Substance Use Disorder Comorbidity in Schizophrenia
Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı

Hatice İmer Aras [1]


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.
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.
  • Arslan E, Altıntaş N, Ayer A, Danacı AE, Aşçı M, Örenay S. Manisa’da şizofren hastaların sitogenetik analiz ve polimeraz zincir reaksiyonu ile COMT (21q11.2) geninin teşhisi. Sağlık Bilimleri Dergisi 2011; 20:99-106.
  • 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.
  • Kozaric-Kovacic D, Folnegovic-Smalc V, Folnegovic Z, Mauric A. Influence of alcoholism on the prognosis of schizophrenic patients. J Stud Alcohol, 1995; 56:622-627. Tarrier N, Picken A. Comorbid PTSD and suicidality in individuals with schizophrenia and substance and alcohol abuse. Soc Pschiatry Psychiatr Epidemiol, 2010; 46:1079-1086.
  • Soyka M, Albus M, Immler B. Psychopathology in dual diagnosis and non-addicted schizophrenics-are there differences? Eur Arch Psychiatry Clin Neurosci 2001; 251:232-238.
  • Kavanagh DJ, McGrath J, Saunders JB. Substance misuse in patients with schizophrenia: epidemiology and management. Drugs 2002; 62:743-755.
  • Smith J, Hucker S. Schizophrenia and substance abuse. Br J Psychiatry 1994; 165:1321
  • Scott H, Johnson S, Menezes P, Thornicroft G, Marshall J, Bindman J et al. Substance misuse and risk of aggression and offending among the severely mentally ill. Br J Psychiatry 1998; 172:345-350.
  • Noordsy DL, Drake RE. Family history of alcoholism in schizophrenia. The Journal of Nervous and Mental Disease 1994; 182:651-655.
  • Barrowclough C, Haddock G, Tarrier N, Lewis SW, Moring J, O’Brien R et al. Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. Am J Psychiatry 2001; 158:1706-1713.
  • Osher FC, Kofoed LL. Treatment of patients with psychiatric and psychoactive substance abuse disorder. Hosp Community Psychiatry 1989; 40:1025-1030.
  • Carey MP, Carey KB. Training mentally ill chemical abusers in social problem solving. Behavior Therapy. 1990; 21:511-518.
  • Schiffman S. Relapse process and relapse prevention in addictive behaviors. The Behavior Therapist 1992; 15:9-11.
  • Bellack AS, Morrison RL, Mueser KT. Social problem solving in schizophrenia. Schizophr Bull 1989; 15:101-116.
  • Liberman L, Massel H. Social skills training for chronic mental patients. Hosp Community Psychiatry 1985; 36:396-403.
  • Drake R, Antosca L, Noordsy D. New Hampshire’s specialized services for the dually diagnosed. In K Minkoff, R Drake (Eds), Dual diagnosis of major mental illness and substance disorders. San Francisco, Jossey-Bass, 1991.
  • Modestin J, Gladen CJ, Christen S. A comparative study on schizophrenic patients with dual diagnosis. J Addict Dis 2001; 20:41-51.
  • Bowers MB Jr, Mazure CM, Nelson C, Jatlow PI. Psychogenetic drug use and neuroleptic response. Schizophr Bull 1990; 16:81-85.
  • Buckley PF. Substance abuse in schizophrenia: a review. J Clin Psychiatry 1998; 59:26-30.
  • Green AI, Salomon MS, Brenner MJ, Rawlins K. Treatment of schizophrenia and comorbid substance use disorder. Curr Drug Targets CNS Neurol Disord 2002; 1:129-139.
  • Le Fauve CE, RZ Litten, CL Randall, DH Moak, IM Salloum, AI Green. Pharmacological treatment of alcohol abuse/dependence with psychiatric comorbidity. Alcoholism: Clin. Exp. Res. 2004; 28:302-312.
  • McEvoy JP, Freudenreich O, Levin ED, Rose JE. Haloperidol increases smoking in patients with schizophrenia. Psychopharmacology 1995; 119:124-126.
  • Gren AI, Zimmet SV, Strous RD, Schildkraut JJ. Clozapine for comorbid substance use disorder and schizophrenia: do patients with schizophrenia have a reward deficiency syndrome that can be ameliorated by clozapine? Harvard Rev Psychiatry 1999; 6:287-296.
  • Roth R, Brunette MF, Green AI. Treatment of substance use disorders in schizophrenia: a unifying neurobiological mechanism? Curr Psychiatry Rep 2005; 7:283-291.
  • Geddes J, Freemantle N, Bebbington P. Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regresion analysis. BMJ 2000; 321:1371-1376.
  • Davis JM, Chen N, Glick ID. A meta-analysis of the efficacy of second generation antipsychotics. Arch Gen Psychiatry. 2003; 60:553-564.
  • Albanese MJ, Khantzian EJ, Murphy SL, Green AI. Decreased substance use in chronically psychotic patients treated with clozapine. Am J Psychiatry 1994; 151:780-781. Yovell Y, Opler LA. Clozapine reverses cocaine craving in a treatment-resistant mentally ill chemical abuser: a case report and a hypothesis. J Nerv Ment Dis 1994; 182:591-592.
  • McEvoy J, Freudenreich O, McGee M, VanderZwaag C, Levin E, Rose J. Clozapine decreases smoking in patients with chronic schizophrenia. Biol Psychiatry 1995; 37:550-552.
  • Buckley P, Thompson P, Way L, Meltzer HY. Substance abuse among patients with treatment-resistant schizophrenia: characteristics and implications for clozapine therapy. Am J Psychiatry 1994; 151:385-389.
  • Drake RE, Xie H, Mc Hugo GJ, Green AI. The effects of clozapine on alcohol and drug use disorders among patients with schizophrenia. Schizophr Bull 2000; 26:4414
  • Green AI, Burgess ES, Dawson R, Zimmet SV, Strous RD. Alcohol and cannabis use in schizophrenia: effects of clozapine vs. risperidone. Schizophr Res 2003; 60:81-85.
  • Lee ML, Dickson RA, Campbell M. Clozapine and substance abuse in patients with schizophrenia. Can J Psychiatry1998; 43:855-856.
  • Buckley P, McCarthy M, Chapman P. Clozapine treatment of comorbid substance abuse in patients with schizophrenia. Schizophr Res 1999; 36:272.
  • Smelson DA, Losonczy MF, Davis CW, Kaune M, Williams J Ziedonis Z. Risperidone decreases craving and relapses in individuals with schizophrenia and cocaine dependence. Can J Psychiatry2002; 47:671-675.
  • Littrell KH, Petty RG, Hilligoss NM, Peaboy CD, Johnson CG. Olanzapin treatment for patients with schizophrenia and substance abuse. J Substance Abuse Treat 2001; 21:217-221.
  • Longo JP. Olanzapine for cocaine craving and relapse prevention in 2 patients. J Clin Psychiatry 2002; 63:595-596.
  • Tsuang J, Marder SR, Han A, Hsieh W. Olanzapine treatment for patients with schizophrenia and cocaine abuse. J Clin Psychiatry 2002; 63:1180-1181.
  • Noordsy DL, O’Keefe C, Mueser KT, Xie H. Six-month outcomes for patients who switched to olanzapine treatment. Psychiatric Serv 2001; 52:501-507.
  • Beresford TP, Clapp L, Martin B, Wiberg JJ, Alfers J, Beresford HF. Aripiprazol in schizophrenia with cocaine dependence: a pilot study. J Clin Psychopharm 2005; 25:363-366.
  • Levin FR, Evans SM, Coomaraswammy S, Collins ED, Regent N, Kleber HD. Flupenthixol treatment for cocaine abusers with schizophrenia: a pilot study. Am J Drug Alcohol Abuse 1998; 24:343-360.
  • O’Malley SS, Krishnan-Sarin S, Farren C, Sinha R Kreek MJ. Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis. Psychopharmacology 2002; 160:19
  • Kranzler HR, Wesson DR, Billot L. Naltrexone Depot for treatment of alcohol dependence: a multicenter, randomized, placebo-controlled clinical trial. Alcoholism Clin Exp Res 2004; 28:1051-1059.
  • Maxwell S, Shinderman MS. Use of naltrexone in the treatment of alcohol use disorders in patients with concomitant major mental illness. J Addict Dis 2000; 19:61-69. Petrakis IL, S’OMalley, Rounsaville B, Poling J, McHugh-Strong C, Krystal JH et al. Naltrexone augmentation of neuroleptic treatment in alcohol abusing patients with schizophrenia. Psychopharmacology 2004; 172: 291-297.
  • Kofoed L, Kania J, Walsh T, Atkinson RM. Outpatient treatment of patients with substance and coexisting psychiatric disorders. Am J Psychiatry 1986; 143:867-872.
  • Mueser KT, Noordsy DL, Fox L, Wolfe R. Disulfiram treatment for alcoholismin severe mental illness. Am J Addict 2003; 12:242-252.
  • Kingsbury SJ, Salzman C. Disulfiram in the treatment of alcoholic patients with schizophrenia. Hosp Community Psychiatry 1990; 41:133-134.
  • Ziedonis DM, Smelson D, Rosenthal RN, Batki SL, Green AI, RJ Henry et al. Improving the care of individuals with schizophrenia and substance use disorders: consensus recommendations. J Psychiatr Pract 2005; 11:315-339.
  • Sass H, Soyka M, Mann K, Zieglgansberger W. Relapse prevention by acamprosate: results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiatry 1996; 53:673-680.
  • Johnson BA, Ait-Daoud N, Bowden CL, DiClemente CC, Roache JD, Lawson K et al. Oral topiramate for treatment of alcohol dependence: a randomised controlled trial. Lancet 2003; 361:1677-1685.
  • George TP, Vessicchio JC, Termine A, Bregartner TA, Feingold A, Rounsaville BJ et al. A placebo controlled trial of bupropion for smoking cessation in schizophrenia. Biol Psychiatry 2002; 52:53-61.
  • Ziedonis DM, Richardson T, Lee E, Petrakis I, Kosten T. Adjunctive desipramine in the treatment of cocaine abuse in schizophrenics. Psychopharmacol Bull 1992; 28:309-314.
  • Siris SG, Mason SE, Bermanzohn PC, Shuwall MA, Aseniero MA. Adjunctive imipramine in substance-abusing dysphoric shcizophrenic patients. Psychopharmacol Bull 1993; 29:127-133.
  • 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
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Yazar: Hatice İmer Aras

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Kabul Tarihi : 5 Temmuz 2020
Yayımlanma Tarihi : 1 Eylül 2013

Bibtex @ { pgy133333, journal = {Psikiyatride Güncel Yaklaşımlar}, issn = {1309-0658}, eissn = {1309-0674}, address = {}, publisher = {Lut TAMAM}, year = {2013}, pages = {260 - 275}, doi = {10.5455/cap.20130517}, title = {Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı}, key = {cite}, author = {Aras, Hatice İmer} }
APA Aras, H . (2013). Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı. Psikiyatride Güncel Yaklaşımlar , 5 (3) , 260-275 . DOI: 10.5455/cap.20130517
MLA Aras, H . "Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı". Psikiyatride Güncel Yaklaşımlar 5 (2013 ): 260-275 <https://dergipark.org.tr/tr/pub/pgy/article/133333>
Chicago Aras, H . "Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı". Psikiyatride Güncel Yaklaşımlar 5 (2013 ): 260-275
RIS TY - JOUR T1 - Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı AU - Hatice İmer Aras Y1 - 2013 PY - 2013 N1 - doi: 10.5455/cap.20130517 DO - 10.5455/cap.20130517 T2 - Psikiyatride Güncel Yaklaşımlar JF - Journal JO - JOR SP - 260 EP - 275 VL - 5 IS - 3 SN - 1309-0658-1309-0674 M3 - doi: 10.5455/cap.20130517 UR - https://doi.org/10.5455/cap.20130517 Y2 - 2020 ER -
EndNote %0 Psikiyatride Güncel Yaklaşımlar Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı %A Hatice İmer Aras %T Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı %D 2013 %J Psikiyatride Güncel Yaklaşımlar %P 1309-0658-1309-0674 %V 5 %N 3 %R doi: 10.5455/cap.20130517 %U 10.5455/cap.20130517
ISNAD Aras, Hatice İmer . "Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı". Psikiyatride Güncel Yaklaşımlar 5 / 3 (Eylül 2013): 260-275 . https://doi.org/10.5455/cap.20130517
AMA Aras H . Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı. pgy. 2013; 5(3): 260-275.
Vancouver Aras H . Şizofrenide Madde Kullanım Bozuklukları Eş Tanısı. Psikiyatride Güncel Yaklaşımlar. 2013; 5(3): 275-260.