Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes
Dual diagnosis of substance abuse in schizophrenia: prevalence and impact on outcomes
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DOI：
10.1016/s0920-9964(98)00161-3
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发表时间：
1999-03-01
影响因子：
4.5
通讯作者：
Dixon, L
中科院分区：
文献类型：
--
作者：
Dixon, L
共病药物滥用障碍已成为有效治疗精神分裂症患者的最大障碍之一。对这种合并症患病率的估计各不相同，但多达一半的精神分裂症患者可能患有合并药物或酒精障碍。年龄较小、男性和受教育程度较低与成瘾风险较高相关。患有精神分裂症和共病成瘾的人往往比那些没有共病成瘾的人更早发作精神分裂症。研究不支持精神分裂症的具体症状与滥用药物的选择之间的联系。相反，药物选择与社区中的环境药物使用模式相关。共病物质障碍与各种不良结局相关，包括精神病症状增加，治疗依从性较差，暴力，住房不稳定和无家可归，医疗问题（包括人类免疫缺陷病毒感染），资金管理不善，以及更多地使用危机导向服务，导致更高的护理费用。过去十年来，在认识到需要将药物滥用治疗与精神健康治疗结合起来，以便为这一人群提供更有效的护理方面取得了相当大的进展。(C)1999 Elsevier Science B.V.保留所有权利。
Comorbid substance abuse disorders have emerged as one of the greatest obstacles to the effective treatment of persons with schizophrenia. Estimates of the prevalence of such comorbidity vary, but as many as half of persons with schizophrenia may suffer from a comorbid drug or alcohol disorder. Younger age, male gender, and lower educational attainment are associated with greater risk for addiction. Persons with schizophrenia and comorbid addiction tend to have an earlier onset of schizophrenia than do those without comorbid addiction. Research does not support a link between specific symptoms of schizophrenia and choice of abused drugs. Rather, drug choice is correlated with the pattern of ambient drug use in the community. Comorbid substance disorders are associated with a variety of poorer outcomes, including increased psychotic symptoms, poorer treatment compliance, violence, housing instability and homelessness, medical problems (including human immunodeficiency virus infection), poor money management, and greater use of crisis-oriented services that result in higher costs of care. Considerable progress has been made over the past decade in understanding the need to integrate substance abuse treatment and mental health treatment to provide more effective care for this population. (C) 1999 Elsevier Science B.V. All rights reserved.