Double jeopardy : schizophrenia and substance use

FRANÇAIS :
Cette étude compare la symptomatologie schizophrénique, les hospitalisations, l'observance du traitement et les variables démographiques entre des usagers de drogues et des non usagers d'une part et entre des consommateurs d'alcool et des consommateurs d'autres drogues d'autre part. Parmi les patients schizophrènes, plus de la moitié ont une histoire passée ou actuelle d'usage de drogues. Ces consommateurs de drogues sont plus jeunes, de sexe masculin en majorité, ont un nombre d'hospitalisations et un taux de rendez-vous manqués plus élevés. Comparés aux consommateurs d'alcool, les usagers de drogues ont nettement plus de symptômes négatifs. L'usage de drogues est également corrélé avec des taux plus élevés de troubles de l'activité motrice et intellectuelle, avec un faible niveau d'éducation et une dose thérapeutique moyenne de neuroleptique plus élevée.
ENGLISH :
The present study examined substance use and compared the broad categories of substance users versus nonusers vis-a-vis schizophrenic symptomatology, hospitalizations, compliance, and demographic variables. We further examined the two subcategories of alcohol versus other substances of abuse (hereafter called "drugs") to determine differences. Results: Of the schizophrenia patients, 55% had a history of past or current substance use. Consistent with previous reports, substance-using schizophrenia patients were more likely to be younger and male than nonusers. appointments in the substance-using patients, and there was a correlation between missed appointments and hospitalizations. As for the differences in the two subcategories of alcohol versus drugs, drug users had notably more negative symptoms, except in those cases for which the alcohol user required treatment for alcoholism. Current drug use also correlated with higher tardive dyskinesia scores, higher incidence of cognitive deficiency, less education, and higher average neuroleptic dose than with nonuse or alcohol use. Conclusion: These results extend the previous findings to a large inner city group of subjects and to a population that is at high risk for relapse. Our findings further emphasize the impact of substance use on outcome in schizophrenia and the need for more research on the nature and treatment of the patient with a dual diagnosis. (From the author' s abstract)