Original articleDrug-use behavior and correlates in people with schizophrenia☆
Section snippets
Participants
Participants were 80 psychiatric outpatients attending an inner city community mental health center: (1) 25 patients with schizophrenia or schizoaffective disorder and co-occurring drug abuse or dependence (SZsub); (2) 25 patients with a major affective disorder and co-occurring drug abuse or dependence (MADsub); and (3) 30 individuals with schizophrenia or schizoaffective disorder and no history of substance abuse or dependence (SZonly). Written informed consent was obtained from all
Results
To control for Type I error, alpha was set at 0.01 for all analyses. All tests were two-tailed and prior to conducting any analyses, distributions were examined for violations of the assumptions necessary to conduct parametric tests. As many of the variables from the ASI had skewed distributions, these data were standardized prior to the creation of the composites and then rank ordered (Alterman et al., in press).
Discussion
The purpose of this study was twofold. The first goal was to increase the understanding of substance use in schizophrenia by addressing three important questions: (1) How do people with schizophrenia access their drugs, maintain their habits, and who are their drug partners?, (2) Why do people with schizophrenia use drugs?, and (3) Are emotional, physical, and sexual abuse prevalent in people with schizophrenia and co-occurring substance-use disorders? The second purpose of the study was to
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Cited by (38)
Cannabis, Cannabinoids, and the Association with Psychosis
2013, The Effects of Drug Abuse on the Human Nervous SystemAbstinence self-efficacy in people with severe mental illness
2013, Journal of Substance Abuse TreatmentCitation Excerpt :We also controlled for substance using motives (social enhancement, personal enhancement, and coping) given that they have also been shown to vary positively with substance use and related problems in people with severe mental illness in ways similar to reasons given by non-SMI groups (Gearon, Bellack, Rachbeisel, & Dixon, 2001; Gregg et al., 2009; O'Hare & Shen, 2012). One consistent finding has shown that coping motives appear to be associated with more problematic substance use overall, particularly in people with major mood disorders (Bolton, Robinson, & Sareen, 2009; Gearon et al., 2001; O'Hare, Shen, & Sherrer, 2010). Having used regression to control for psychiatric symptoms in a sample of people with SMI (which overlaps with the current sample), O'Hare and Shen found that coping motives varied positively and significantly with alcohol use and substance use problems, but personal enhancement motives varied with drug use.
Development and validation of a scale for assessing reasons for substance use in schizophrenia: The ReSUS scale
2009, Addictive BehaviorsCitation Excerpt :There is less consensus about whether people use substances for reasons directly related to schizophrenia however (as suggested by Khantzian, 1985, 1997), either in terms of psychotic symptoms, the distress associated with those symptoms or the side effects of neuroleptic medication. Only a handful of studies have reported that people experiencing psychosis report using substances to self medicate (Addington & Duchak, 1997; Gearon, Bellack, Rachbeisel, & Dixon, 2001; Goswami, Mattoo, Basu, & Singh, 2004; Spencer, Castle, & Michie, 2002) but because of sampling and methodological differences (in the way that dual diagnosis was defined; the diagnostic criteria used for substance use and the variety of measures to assess reasons for use) it is difficult to draw firm conclusions about these results. In an attempt to address some of the methodological limitations of the earlier self report studies Gregg, Haddock and Barrowclough (2009) used Q methodology (Stephenson, 1953) to examine reasons for use by people with a diagnosis of schizophrenia and current comorbid substance use.
Application of the Transtheoretical Model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness
2008, Addictive BehaviorsCitation Excerpt :Most of the “pros” assessed on the Decisional Balance Scale focus on using drugs to cope with unpleasant emotions or regulate affect; it is possible these items were more frequently endorsed in the affective disorder group because of the frequent experience of negative affect among people with affective disorders. Studies of people with different forms of SMI have found that while people with schizophrenia generally report relief of boredom and peer pressure and main reasons for their drug use, people with affect disorders are more likely to report drug use to lessen negative emotions (Gearon, Bellack, Rachbeisel, & Dixon, 2001). However, individuals with schizophrenia have also reported that a primary reason for using drugs is to reduce depression (Addington & Duchak, 1997; Dixon, Haas, Weiden, Sweeney & Frances, 1991).
Reasons for increased substance use in psychosis
2007, Clinical Psychology ReviewDeterminants of functioning and well-being among individuals with schizophrenia: An integrated model
2007, Clinical Psychology Review
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Preparation of this manuscript was supported in part by NIH grants DA11199-01 (JSG) and DA09406 (ASB) from NIDA, and the VA Capital Network MIRECC (ASB).