Prevalence of substance abuse in schizophrenia: demographic and clinical correlates.
Prevalence of substance abuse in schizophrenia: demographic and clinical correlates.
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精神分裂症中药物滥用的患病率：人口统计学和临床相关性。
DOI：
10.1093/schbul/16.1.31
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发表时间：
1990
影响因子：
6.6
通讯作者：
Yadalam,KG
中科院分区：
文献类型：
--
作者：
Mueser,KT;Yarnold,PR;Levinson,DF;Singh,H;Bellack,AS;Kee,K;Morrison,RL;Yadalam,KG
精神分裂症药物滥用的患病率评估方法的问题进行了讨论，并在这方面的以往研究进行了全面的审查。许多研究都存在方法上的缺陷，包括缺乏诊断的严谨性、足够的样本量以及同时评估不同类型的药物滥用（例如，兴奋剂、镇静剂）。总的来说，证据表明，精神分裂症患者滥用药物的流行率与一般人群相当，但兴奋剂和致幻剂滥用可能是例外，精神分裂症患者的滥用率可能更高。本文介绍了149例最近住院的DSM-III-R精神分裂症、精神分裂症样和情感性精神障碍患者药物滥用与人口统计学、诊断、病史和症状的相关性。人口统计学特征是药物滥用的强有力的预测因子，其中性别、年龄、种族和社会经济地位是最重要的。兴奋剂滥用者往往在较早的年龄首次住院，更经常被诊断为精神分裂症，但他们的症状与非滥用者没有区别。大麻滥用史与较少的症状和以前的住院治疗有关，这表明更有社会能力的患者倾向于使用大麻。研究结果表明，环境因素可能是精神分裂症谱系患者药物滥用的重要决定因素，与滥用有关的临床差异因药物类型而异。
Methodological issues involved in assessing the prevalence of substance abuse in schizophrenia are discussed, and previous research in this area is comprehensively reviewed. Many studies suffer from methodological shortcomings, including the lack of diagnostic rigor, adequate sample sizes, and simultaneous assessment of different types of substance abuse (e.g., stimulants, sedatives). In general, the evidence suggests that the prevalence of substance abuse in schizophrenia is comparable to that in the general population, with the possible exceptions of stimulant and hallucinogen abuse, which may be greater in patients with schizophrenia. Data are presented on the association of substance abuse with demographics, diagnosis, history of illness, and symptoms in 149 recently hospitalizedDSM-III-Rschizophrenic, schizophreniform, and schizoaffective disorder patients. Demographic characteristics were strong predictors of substance abuse, with gender, age, race, and socioeconomic status being most important. Stimulant abusers tended to have their first hospitalization at an earlier age and were more often diagnosed as having schizophrenia, but did not differ in their symptoms from nonabusers. A history of cannabis abuse was related to fewer symptoms and previous hospitalizations, suggesting that more socially competent patients were prone to cannabis use. The findings show that environmental factors may be important determinants of substance abuse among schizophrenic-spectrum patients and that clinical differences related to abuse vary with different types of drugs.
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