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The vulnerability to alcohol and substance abuse in individuals diagnosed with schizophrenia
(La vulnérabilité à l'abus d'alcool et d'autres substances chez les individus diagnostiqués avec une schizophrénie.)
Auteur(s) :
KRYSTAL, J. H. ;
D'SOUZA, D. C. ;
GALLINAT, J. ;
DRIESEN, N. ;
ABI-DARGHAM, A. ;
PETRAKIS, I. ;
HEINZ, A. ;
PEARLSON, G.
Année
2006
Page(s) :
235-252
Sous-type de document :
Revue de la littérature / Literature review
Langue(s) :
Anglais
Refs biblio. :
171
Domaine :
Plusieurs produits / Several products
Discipline :
PSY (Psychopathologie / Psychopathology)
Thésaurus mots-clés
SCHIZOPHRENIE
;
ABUS
;
ALCOOL
;
FACTEUR DE VULNERABILITE
;
NEUROBIOLOGIE
;
TABAC
;
CANNABIS
;
IMAGERIE MEDICALE
;
NEUROTRANSMETTEURS
Note générale :
Neurotoxicity Research, 2006, 10, (3-4), 235-252
Résumé :
ENGLISH:
Individuals with schizophrenia are at increased risk for developing substance abuse disorders. Here, we consider factors that might elevate their risk for substance abuse. The tendency among schizophrenic individuals to overvalue drug-like rewards and to devalue the potential negative consequences of substance abuse may be a contributing factor to their substance abuse risk. This bias, which may partly reflect the convergence of glutamatergic and dopaminergic input to the limbic striatum, also may contribute to disadvantageous decision-making and other impulsive behavior. This propensity to seek drug-like rewards is augmented by alterations in nicotinic cholinergic, GABAergic, glutamatergic, and cannabinnoid receptor function associated with schizophrenia that increase the abuse liability of low doses of nicotine, ethanol, and perhaps cannabis, and augment the dysphoric effects of higher doses of ethanol and cannabis. The distortions in reward processing and altered response to substances of abuse also increase the likelihood that individuals with schizophrenia will self-medicate their subjective distress with abused substances. The focus on distinctions between motivation and reward with respect to substance abuse risk by schizophrenic patients suggests a need for a reconsideration of the construct of "negative symptoms" for this dually-diagnosed patient group. (Author' s abstract)
Individuals with schizophrenia are at increased risk for developing substance abuse disorders. Here, we consider factors that might elevate their risk for substance abuse. The tendency among schizophrenic individuals to overvalue drug-like rewards and to devalue the potential negative consequences of substance abuse may be a contributing factor to their substance abuse risk. This bias, which may partly reflect the convergence of glutamatergic and dopaminergic input to the limbic striatum, also may contribute to disadvantageous decision-making and other impulsive behavior. This propensity to seek drug-like rewards is augmented by alterations in nicotinic cholinergic, GABAergic, glutamatergic, and cannabinnoid receptor function associated with schizophrenia that increase the abuse liability of low doses of nicotine, ethanol, and perhaps cannabis, and augment the dysphoric effects of higher doses of ethanol and cannabis. The distortions in reward processing and altered response to substances of abuse also increase the likelihood that individuals with schizophrenia will self-medicate their subjective distress with abused substances. The focus on distinctions between motivation and reward with respect to substance abuse risk by schizophrenic patients suggests a need for a reconsideration of the construct of "negative symptoms" for this dually-diagnosed patient group. (Author' s abstract)
Affiliation :
Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
Etats-Unis. United States.
Etats-Unis. United States.
Cote :
A03196