Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment

1992 ◽  
Vol 22 (2) ◽  
pp. 379-388 ◽  
Author(s):  
Stephan Arndt ◽  
Gary Tyrrell ◽  
Michael Flaum ◽  
Nancy C. Andreasen
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Common Factor ◽  
Clinical History ◽  
Psychotic Illness ◽  
Co Morbidity ◽  
Schizophrenic Patients ◽  
The Individual ◽  
Subsequent Onset

SYNOPSISCo-morbid substance use and abuse is common in schizophrenic patients, and the role of substance abuse in initiating and maintaining psychosis has important definitional and aetiological implications. We investigated the issue in a cohort of 131 schizophrenic patients. We found non-users (N = 67) were similar to pathological users (N = 64) in current symptomatology and clinical history. The pathological users did, however, have better pre-morbid adjustment levels. Only alcohol use and to some extent cannabis use contributed to this effect; use of stimulants or hallucinogens did not. These results indicate the importance of evaluating the various types of substance used when attempting to explore the significance of co-morbidity. The results also suggest that co-morbidity of substance abuse and schizophrenia may be explained by a common factor antecedent to both: better pre-morbid adjustment. A two-stage model is proposed to explain these findings: increased sociability increases exposure to opportunities of substance use in a subset of patients; subsequent onset of psychotic illness accelerates the use to a pathological level as the individual attempts to cope with the stress of the developing mental illness.

The Role of Controlled Substance Use in Diversion Outcomes Among Mentally Ill Offenders: A Pilot Study

2017 ◽  
Vol 62 (9) ◽  
pp. 2709-2725
Author(s):  
Jennifer K. Boland ◽  
Barry Rosenfeld
Keyword(s):  
New York ◽  
Substance Abuse ◽  
Substance Use ◽  
Psychotic Disorders ◽  
Mentally Ill Offenders ◽  
Program Participation ◽  
Diversion Programs ◽  
Diversion Program ◽  
Drug History

Diversion programs offer opportunities to offenders with substance abuse or mental illness to attend treatment as an alternative to incarceration. The present study identified variables associated with drug relapse and recidivism and the moderating role of substance use on recidivism in a diversion sample. Data were collected from 80 clients with psychotic disorders from a diversion program in New York City. Outcomes were examined after 6 and 12 months of program participation. Individuals who used controlled substances other than alcohol or cannabis were more likely to have a positive toxicology result than those who used alcohol or cannabis only or those with no alcohol/drug history. Individuals with schizoaffective disorder were more likely to be rearrested than individuals with other diagnoses, as were those with a violent offense (e.g., assault, robbery). Positive toxicology results were unrelated to rearrest and did not moderate recidivism, suggesting substance abuse may be only indirectly related to rearrest among diverted offenders.

scholarly journals Substance abuse, drug addiction and the role of primary health care amid the COVID-19 pandemic

2021 ◽  
Vol 8 (12) ◽  
pp. 6175
Author(s):  
Mustafa Elsaied Esmail ◽  
Majed Diaa Mosly ◽  
Abdulaziz Abdullah Alghamdi ◽  
Alalaa Hussain Hakami ◽  
Ahmed Ali Majrashi ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Drug Abuse ◽  
Drug Addiction ◽  
Substance Addiction ◽  
Clinical Complications ◽  
Significant Difference ◽  
Care Facilities ◽  
Definition Of ◽  
The Individual

The definition of substance abuse is the use of certain types of drugs such as alcohol, cannabis, hash, cocaine and others that have serious side effects and clinical complications. There is a significant difference between substance abuse and the term addiction. The significant difference between substance abuse and addiction is that drug addiction or substance addiction is classified as a chronic disease controlling the physical and mental ability of the individual to unpleasant force to use specific drugs such as cocaine or else. The literature has a positive correlation between the COVID-19 pandemic and illegal drug abuse in substance abuse or addiction. COVID-19 caused emotional emptiness for many people around the world, in addition to anxiety and depression. The particular group of people started addicting to specific drugs to induce temporary happiness due to the unpleasant events they had from the pandemic. This article aimed to review the challenges of substance abuse and drug abuse in the COVID-19 pandemic and the role of public health in addition to primary care facilities against this phenomenon. To our knowledge, this is the first review providing a complex review about this issue since the beginning of COVID-19.

Prevalence and severity of substance use disorders and onset of psychosis in first-admission psychotic patients

1998 ◽  
Vol 28 (6) ◽  
pp. 1411-1419 ◽  
Author(s):  
J. RABINOWITZ ◽  
E. J. BROMET ◽  
J. LAVELLE ◽  
G. CARLSON ◽  
B. KOVASZNAY ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Age Of Onset ◽  
Antisocial Behaviour ◽  
Life Time ◽  
Psychotic Illness ◽  
Current Cigarette Smoking ◽  
Severity Rating ◽  
First Admission

Background. Past studies have found inconsistent evidence that substance use disorders are related to earlier onset of schizophrenia or more severe symptoms. This study examines prevalence and severity of current substance use disorders and onset of psychotic illness in a multi-facility sample.Methods. Data are from the Suffolk County Mental Health Project, an epidemiological study of first admission psychosis. The SCID and instruments measuring symptomatology, personality and background characteristics were administered. Respondents were stratified into three groups: (a) no life-time substance diagnosis; (b) in remission or reporting current mild use at admission; and (c) current moderate–severe substance abuse at admission.Results. Using the SCID severity rating, 17·4% of males and 6·2% of the females had moderate or severe current substance abuse, while 41·5% of males and 68·2% of females had no lifetime substance diagnosis. In almost all cases categorized as moderate–severe, the substance diagnosis predated onset of psychosis. Females categorized as moderate–severe had an earlier age of onset of psychosis than did females in the other groups. There were only slight differences in symptom severity among the groups but more marked antisocial behaviour in the moderate–severe group. Variables discriminating the moderate–severe from non-abuse groups were BPRS thought disturbance, adult anti-social behaviour and current cigarette smoking for males and adult antisocial behaviour and child–teen antisocial behaviour for females.Conclusions. Severity of substance abuse does not appear to be a pivotal correlate of the early features of psychotic illness.

Some Aspects of Social Phobia and its Relationship with Substance use Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
N. Dostanic ◽  
A. Djeric ◽  
J. Daragan-Saveljic ◽  
S. Raicevic
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Social Phobia ◽  
Substance Use Disorder ◽  
Daily Living ◽  
Substance Abusers ◽  
Social Situations ◽  
Co Morbidity ◽  
Research Findings ◽  
Withdrawal Syndromes

Social Phobia (SP) is one of the most prevalent anxiety disorder, characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. This excessive anxiety usually leads to avoidance behavior that can severely affect normal daily living. SP usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved.A number of studies have emphasized the high co-morbidity of social phobia with a number of other psychiatric disorders, including substance use disorders. Though clearly elevated there is much debate as to the nature of this relationship. Substance abuse may develop if people try to self-medicate their anxiety and make thamselves more comfortable in social situations. Anxiety may be a result of alcohol or drug abuse due to a substance's anxiogenic effects or through protracted withdrawal syndromes. Substance abusers incur more pathological and unstable life circumstances, making them more susceptible to future stress and anxiety; and there may be a genetic susceptibility in some people which makes them vulnerable to both disorders.The purpose of this article is to summarize research findings on SP and its complex relationship with substance use disorder. Clinical anxiety and substance abuse both warrant treatment and in all likelihood, each helps perpetuate the other.

Examining the Role of Substance Abuse in Elder Mistreatment: Results From Mistreatment Investigations

2016 ◽  
Vol 34 (2) ◽  
pp. 366-391 ◽  
Author(s):  
Kendon J. Conrad ◽  
Pi-Ju Liu ◽  
Madelyn Iris
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Physical Abuse ◽  
Emotional Abuse ◽  
Risk Identification ◽  
Elder Mistreatment ◽  
Cross Sectional ◽  
Substance Use Problems ◽  
Financial Exploitation

Substance abuse has long been identified as a risk factor for elder mistreatment, yet research on the topic remains sparse. This study tested hypotheses whether perpetrator and victim substance use problems were associated with financial exploitation, physical abuse, emotional abuse, and neglect versus no abuse. Cross-sectional data were collected on 948 cases with yes/no substantiation decisions where 357 cases had no abuse in elder mistreatment investigations. Hypotheses were tested using odds ratios, bivariate, and multiple linear regression analyses including a control for victim vulnerability. Of 948 alleged victims, 42 (4.4%) exhibited signs of substance use problems. Among the 323 alleged perpetrators, 87 (26.9%) were reported to have substance use problems. Substance use problems by alleged perpetrators were associated ( p < .01) with financial exploitation, physical abuse, and emotional abuse but not neglect. Substance use problems by alleged victims were associated with neglect, but not the other types. Alleged perpetrators with substance use problems tended to commit multiple forms of abuse, were male and not caregivers. Except for the findings on neglect, the associations with elder mistreatment were stronger for alleged perpetrators with substance use problems, than for alleged victims. Clarification of the role of perpetrator risk factors such as substance abuse should improve risk identification and subsequent intervention.

scholarly journals Medication compliance in schizophrenic out patients with psychoactive substance use co-morbidity: a cross-sectional study

2021 ◽  
Vol 10 (1) ◽  
pp. 167
Author(s):  
Saurabh Ahlawat ◽  
Vikrant Aggarwal ◽  
Rakesh Kumar
Keyword(s):  
Substance Use ◽  
Medication Adherence ◽  
Rating Scale ◽  
Medication Compliance ◽  
Cross Sectional Study ◽  
High Rate ◽  
Psychoactive Substance ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Schizophrenic Patients

Background: Medication adherence is an important issue in the treatment and management of persons with psychiatric disorders including schizophrenia. Apart from side effects and inefficient outcomes of psychiatric medications, substance abuse also complicates the adherence pattern to the prescribed medications. Present study was designed to estimate the magnitude of medication non-adherence and its correlates in patients with schizophrenia having co-morbid psychoactive substance use.Method: The 60 schizophrenic patients with active substance use were taken from OPD of institute of mental health and hospital, Agra. Positive and negative syndrome scale (PANSS), alcohol, smoking and substance involvement screening test (ASSIST), medication adherence rating scale (MARS) and Morisky 8-item medication adherence questionnaire (MMAQ-8) were used to gather relevant clinical data along with a proforma for recording socio-demographic characteristics.Results: The results revealed an alarming level of medication adherence. The 91.7% sample (55 patients) met the criteria for medication non-adherence. Majority of the patients were using alcohol (58.3%) and cannabis (51.7%). Conclusions: Given the high rate of medication non-compliance it is suggested that specific intervention aimed at compliance to prescribed medication is needed in this population.

scholarly journals Substance abuse as a cause of violence in persons diagnosed with schizophrenia

Temida ◽  
2013 ◽  
Vol 16 (2) ◽  
pp. 17-32
Author(s):  
Aleksandar Dimitrijevic ◽  
Anja Zivkovic ◽  
Masa Bozovic
Keyword(s):  
Substance Abuse ◽  
General Population ◽  
Violent Behavior ◽  
Public Image ◽  
Co Morbidity ◽  
Substance Abuse Disorders ◽  
Violent Acts ◽  
Persons With Schizophrenia ◽  
Meta Analyses

Persons diagnosed with schizophrenia can both inflict and suffer violence. For centuries there has been a firmly held belief that they are dangerous and, due to this belief, they are still frequently isolated from the community and exposed to involuntary treatment and restraint. Research data illustrates that persons with this diagnosis are at greater risk of performing violent acts more frequently than the general population. In recent years, the general framework has been set in a more complex manner due to the inclusion in analysis of several mediating variables such as gender, social status, childhood trauma, personality traits, stress and many others. Numerous studies have shown that violent tendencies are evident in persons with co-morbidity of schizophrenia and anti- social personality disorder and/or substance abuse disorders. This paper is focused on reviewing data scrutinizing the role of drug abuse and alcoholism in the violent behavior of persons diagnosed with schizophrenia. Data obtained through meta- analyses of tens of thousands of cases demonstrates unequivocally that the percentage of persons with schizophrenia who commit violent acts without abusing drugs is relatively higher than in the general population (8.5% : 5.3%), while persons who abuse drugs and/or alcohol have been more frequently violent regardless of being psychotic or not (27.6%). Having taken these findings into account, the understanding that persons diagnosed with schizophrenia are prone to violence must be made more specific and their treatment, follow- up and public image changed accordingly. Some of these implications are discussed in this paper and changes suggested.

What Did You Expect? Substance Use Expectancies Mediate the Relationships Between Dark Triad Traits, Substance Use, and Substance Preference

2018 ◽  
Vol 121 (5) ◽  
pp. 831-852 ◽  
Author(s):  
Adam Jordan Gott ◽  
Melanie D. Hetzel-Riggin
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Cognitive Enhancement ◽  
Dark Triad ◽  
Clinical Implications ◽  
Online Questionnaire ◽  
Specific Substance ◽  
Substances Of Abuse

This study explores the role of substance use expectancies as mediators between the Dark Triad of personality, substance use, and substance use preferences. A sample of college students ( M = 19.38, SD = 2.63, N = 207) completed an online questionnaire that assessed the Dark Triad traits, substance use history, substance preferences, and substance use expectancies. Three specific substance use expectancies—increased confidence, tension reduction, and cognitive enhancement—were shown to either partially or fully mediate the relationships between the Dark Triad and substance use behaviors and preference for certain substances of abuse. These findings may hold clinical implications for the treatment of substance use disorders and further the understanding of factors contributing to the etiology and progression of substance abuse and substance use disorders.

scholarly journals Neuroimmune Mechanisms as Novel Treatment Targets for Substance Use Disorders and Associated Comorbidities

2021 ◽  
Vol 15 ◽  
Author(s):  
Mark D. Namba ◽  
Jonna M. Leyrer-Jackson ◽  
Erin K. Nagy ◽  
M. Foster Olive ◽  
Janet L. Neisewander
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Nervous System ◽  
Synaptic Plasticity ◽  
Substance Use Disorders ◽  
Immune Signaling ◽  
Treatment Targets ◽  
Novel Treatment ◽  
The Brain

Recent studies examining the neurobiology of substance abuse have revealed a significant role of neuroimmune signaling as a mechanism through which drugs of abuse induce aberrant changes in synaptic plasticity and contribute to substance abuse-related behaviors. Immune signaling within the brain and the periphery critically regulates homeostasis of the nervous system. Perturbations in immune signaling can induce neuroinflammation or immunosuppression, which dysregulate nervous system function including neural processes associated with substance use disorders (SUDs). In this review, we discuss the literature that demonstrates a role of neuroimmune signaling in regulating learning, memory, and synaptic plasticity, emphasizing specific cytokine signaling within the central nervous system. We then highlight recent preclinical studies, within the last 5 years when possible, that have identified immune mechanisms within the brain and the periphery associated with addiction-related behaviors. Findings thus far underscore the need for future investigations into the clinical potential of immunopharmacology as a novel approach toward treating SUDs. Considering the high prevalence rate of comorbidities among those with SUDs, we also discuss neuroimmune mechanisms of common comorbidities associated with SUDs and highlight potentially novel treatment targets for these comorbid conditions. We argue that immunopharmacology represents a novel frontier in the development of new pharmacotherapies that promote long-term abstinence from drug use and minimize the detrimental impact of SUD comorbidities on patient health and treatment outcomes.

scholarly journals Individual differences in the effects of priors on perception: a multi-paradigm approach

2019 ◽  
Author(s):  
Kadi Tulver ◽  
Jaan Aru ◽  
Renate Rutiku ◽  
Talis Bachmann
Keyword(s):  
Individual Differences ◽  
Common Factor ◽  
General Pattern ◽  
Representational Momentum ◽  
Clinical Population ◽  
Pairwise Correlations ◽  
The Face ◽  
Behavioural Performance ◽  
The Individual

AbstractThe present study investigated individual differences in how much subjects rely on prior information, such as expectations or knowledge, when faced with perceptual ambiguity. The behavioural performance of forty-four participants was measured on four different visual paradigms (Mooney face recognition, illusory contours, blur detection and representational momentum) in which priors have been shown to affect perception. In addition, questionnaires were used to measure autistic and schizotypal traits in the non-clinical population. We hypothesized that someone who in the face of ambiguous or noisy perceptual input relies heavily on priors, would exhibit this tendency across a variety of tasks. This general pattern would then be reflected in high pairwise correlations between the behavioural measures and an emerging common factor. On the contrary, our results imply that there is no single factor that explains the individual differences present in the aforementioned tasks, as further evidenced by the overall lack of robust correlations between the separate paradigms. Instead, a two-factor structure reflecting differences in the hierarchy of perceptual processing was the best fit for explaining the individual variance in these tasks. This lends support to the notion that mechanisms underlying the effects of priors likely originate from several independent sources and that it is important to consider the role of specific tasks and stimuli more carefully when reporting effects of priors on perception.

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