RESUMO
The prevalence and course of alcohol and drug use were examined in a longitudinal, retrospective study of 100 schizophrenic outpatients. During the 18 month study period, problem substance use (abuse and dependence) was not associated with differential attrition from outpatient treatment. Thirty to forty percent of subjects were using drugs or alcohol during any evaluation period. The overall level of substance use and problem use of alcohol, marijuana, and other drugs remained stable, while problem use of cocaine and multiple substances increased over time. Problem substance use was associated with lower functional status and the detrimental effect of problem substance use appeared to increase with time. These findings underscore the need to address substance use problems in the context of outpatient schizophrenia treatment.
Assuntos
Alcoolismo/epidemiologia , Drogas Ilícitas , Psicotrópicos , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Alcoolismo/psicologia , Alcoolismo/reabilitação , Assistência Ambulatorial , Terapia Combinada , Comorbidade , Estudos Transversais , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pacientes Desistentes do Tratamento/psicologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , São Francisco/epidemiologia , Esquizofrenia/reabilitação , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/reabilitaçãoRESUMO
The authors report the findings of a longitudinal study testing the hypothesis that substance use leads to subsequent violence in the community. Subjects were 103 patients with a Structured Clinical Interview for DSM-III-R diagnosis of schizophrenia or schizoaffective disorder who were seen in an outpatient clinic for the treatment of schizophrenia. Data on substance use and violent behavior were collected by review of medical records. Results indicated that use of drugs and alcohol was associated with increased odds of concurrent and future violent behavior when compared with persons with schizophrenia and no substance use. Odds of violence were particularly elevated for individuals having a pattern of polysubstance use involving illicit substances.
Assuntos
Psicologia do Esquizofrênico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Violência , Adolescente , Adulto , Assistência Ambulatorial , Estudos Transversais , Feminino , Humanos , Drogas Ilícitas , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Probabilidade , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/complicações , Esquizofrenia/complicações , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
Markov models were used to examine patterns of substance use and global functioning in a sample of 100 schizophrenic outpatients over an 18 month period. Patterns of changes in substance use and functional status were stable across the evaluation period. Persons remaining in any substance use or functional state for two evaluation periods were highly likely to continue in the same state. Tests of two common causal hypotheses about relationships between substance use and functional status yielded partial support for the hypothesis that substance use leads to functional impairment, but did not support the hypothesis that functional impairment leads to substance use. Furthermore, there was no evidence of any increase in overall substance use or of substance use leading to treatment dropout. These analyses illustrate a promising approach to key questions about substance use in schizophrenia.