Precipitation and determination of the onset and course of schizophrenia by substance abuse -: a retrospective and prospective study of 232 population-based first illness episodes
Precipitation and determination of the onset and course of schizophrenia by substance abuse -: a retrospective and prospective study of 232 population-based first illness episodes
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DOI：
10.1016/s0920-9964(01)00249-3
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发表时间：
2002-04-01
影响因子：
4.5
通讯作者：
Häfner, H
中科院分区：
文献类型：
--
作者：
Bühler, B;Hambrecht, M;Häfner, H
在以人群为基础的IRAOS访谈中，回顾性地评估了药物滥用的发病和终生患病率。232例首发精神分裂症的对照样本（ABC样本）。精神分裂症患者在首次入院时有终生药物滥用史的可能性是对照组的两倍（酒精滥用：23.7%对12.3%；药物滥用：14.2%对7.0%）。88%的吸毒患者吸食大麻。对药物滥用与精神分裂症的先后顺序进行了药物滥用发病时间和疾病发病时间的研究。后者基于各种定义：疾病的首次症状，首次精神病症状和首次入院。62%的药物滥用患者和51%的酒精滥用患者在发病前就开始有这种习惯（=疾病的第一个迹象）。药物滥用的发生和疾病的发生在同一个月内非常显著（药物滥用占34.6%，酒精滥用占18.2%）。出乎意料的是，在虐待发作和第一次精神病发作之间没有发现时间相关性。我们得出的结论是，一小部分精神分裂症可能是由滥用药物（主要是大麻）引起的。从115例精神分裂症首次发作的子样本开始，在5年内对早期药物滥用的长期影响进行了前瞻性研究。与对照组相比，滥用者明显表现出更多的阳性症状，情感扁平化程度也有所下降。基于治疗依从性、康复措施使用率和就业率的五年结果，早期药物滥用的患者也比没有药物滥用的患者差。(C) 2002 Elsevier Science B.V.版权所有
Onset and lifetime prevalence of substance abuse were assessed retrospectively using the IRAOS interview in a population-based. controlled sample of 232 first episodes of schizophrenia (ABC sample). Subjects with schizophrenia were twice as likely as controls to have a lifetime history of substance abuse at the age of first admission (alcohol abuse: 23.7 versus 12.3%; drug abuse: 14.2 versus 7.0%). 88% of the patients with drug abuse took cannabis. The sequence of substance abuse and schizophrenia was studied on the timing of abuse onset and illness onset. the latter as based on various definitions: first sign of the disorder, first psychotic symptom and first admission. 62% of the patients with drug abuse and 51% of those with alcohol abuse began the habit before illness onset ( = first sign of the disorder). Abuse onset and illness onset occurred highly significantly within the same month (drug abuse in 34.6%, alcohol abuse in 18.2%). Unexpectedly, no temporal correlation was found between abuse onset and the onset of the first psychotic episode. We concluded that a small proportion of schizophrenias might have been precipitated by substance - mainly cannabis - abuse.Long-term effects of early substance abuse were studied prospectively at six cross-sections over five years from first admission on in a subsample of 115 first episodes of schizophrenia. Abusers showed signficantly more positive symptoms and a decrease in affective flattening compared with controls. Five-year outcome as based on treatment compliance, utilization of rehabilitative measures and rate of employment was also poorer for patients with than without early substance abuse. (C) 2002 Elsevier Science B.V. All rights reserved.