Substance abuse treatment for people with schizophrenia

FRANÇAIS :
Cet article donne d'abord un aperçu des conséquences de l'abus de drogues chez les patients schizophrènes, et examine les connaissances actuelles sur leurs besoins en traitement. Cette population connaît des problèmes particuliers qui interagissent sur leur capacité à réduire leur usage de drogues, avec ou sans traitement. Les auteurs s'emploient alors à décrire un nouveau traitement comportemental tendant à compenser les déficits cognitifs et le manque de motivation qui caractérisent cette maladie. Ils présentent le processus de développement et quelques données démontrant la validité de l'intervention pour les patients schizophrènes, et la possibilité de forme des intervenants pour gérer les procédures de manière constante et efficace.
ENGLISH :
Substance abuse by people with schizophrenia is a serious public health problem that is associated with poor treatment compliance, increased rates of relapse, and disruption of role functioning. There is widespread agreement on the need to integrate psychiatric and substance abuse treatment for this dual disorder, but to date there are no specific treatments with solid empirical support. The authors first review the primary consequences of substance abuse by people with schizophrenia and then examine what is currently known about their treatment needs. They describe the special problems faced by this population that interfere with their ability to reduce substance use, with or without treatment. The remainder of the paper focuses on description of a new behavioral treatment they have developed to compensate for the cognitive and motivational deficits that characterize the illness. They describe the development process and present some process data that demonstrate that the intervention is safe and acceptable for people with schizophrenia, and that they are able to train therapists to administer the procedures in a consistent and effective manner. (Authors'abstract)