Patterns of current and lifetime substance use in schizophrenia
Patterns of current and lifetime substance use in schizophrenia
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DOI：
10.1093/oxfordjournals.schbul.a033339
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发表时间：
1998-01-01
影响因子：
6.6
通讯作者：
Lewin, TJ
中科院分区：
文献类型：
--
作者：
Fowler, IL;Carr, VJ;Lewin, TJ
结构化访谈和标准化评定量表被用来评估样本的194个精神分裂症门诊患者在区域澳大利亚精神卫生服务的物质使用，滥用和依赖。病例管理者评估和尿液药物筛查也用于确定物质使用。其他测量包括人口统计学信息，刑事指控史，症状自我报告，个人幸福感和社会支持。样本主要是男性，在住宿方面表现出相对的不稳定性，几乎一半有刑事犯罪史，最常见的是毒品或酒精相关。药物滥用或依赖的6个月和终生流行率分别为26.8%和59.8%，酒精、大麻和安非他明是最常滥用的药物。目前酒精使用者占77.3%，其他非处方物质（不包括烟草和咖啡因）的使用者占29.9%。烟草和咖啡因的消费率很高。有一个中等程度的一致性之间的情况下经理确定的物质使用问题和研究诊断。当前或终生诊断为药物滥用/依赖的受试者主要是年轻的单身男性，刑事指控率较高;然而，与既往或当前未诊断为药物滥用或依赖的受试者相比，没有证据表明这些组的自杀企图率、住院率或抗精神病药物每日剂量增加。目前诊断为物质使用的受试者在首次治疗时较年轻，目前症状比既往或目前未诊断为物质使用的受试者更明显。从这项研究中出现的情况复制了北美研究中报告的精神分裂症患者的高药物滥用率，但与后者不同的是，发现滥用药物的模式略有不同（即，没有可卡因），反映了某些药物供应的相对差异。
A structured interview and standardized rating scales were used to assess a sample of 194 outpatients with schizophrenia in a regional Australian mental health service for substance use, abuse, and dependence. Case manager assessments and urine drug screens were also used to determine substance use. Additional measurements included demographic information, history of criminal charges, symptom self-reports, personal hopefulness, and social support. The sample was predominantly male and showed relative instability in accommodations, and almost half had a history of criminal offenses, most frequently drug or alcohol related. The 6-month and lifetime prevalence of substance abuse or dependence was 26.8 and 59.8 percent, respectively, with alcohol, cannabis, and amphetamines being the most commonly abused substances. Current users of alcohol comprised 77.3 percent and current users of other nonprescribed substances (excluding tobacco and caffeine) comprised 29.9 percent of the sample. Rates of tobacco and caffeine consumption were high. There was a moderate degree of concordance between case manager determinations of a substance-use problem and research diagnoses. Subjects with current or lifetime diagnoses of substance abuse/dependence were predominantly young, single males with higher rates of criminal charges; however, there was no evidence of increased rates of suicide attempts, hospital admissions, or daily doses of antipsychotic drugs in these groups compared with subjects with no past or current diagnosis of substance abuse or dependence. Subjects with a current diagnosis of substance use were younger at first treatment and currently more symptomatic than those with no past or current substance use diagnosis. The picture emerging from this study replicates the high rate of substance abuse in persons with schizophrenia reported in North American studies but differs from the latter in finding a slightly different pattern of substances abused (i.e., absence of cocaine), reflecting relative differences in the availability of certain drugs.