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Objective: Co-occurring nicotine, alcohol, and drug use among patients with schizophrenia is high. Comorbidity of alcohol and drug use may worsen functionality. Prevalence of alcohol and drug use among patients with schizophrenia is reported as 10-70% and nicotine use escalates this rate up to 80%. Epidemiologic Catchment Area Study showed that prevalence of alcohol and drug use disorders is 47%. Studies on comorbidity of alcohol-drug use disorders and schizophrenia are limited in Turkey. One of the largest study on this area showed that 50% of patients with schizophrenia has a co-occurring alcohol or drug use, 17% of patients were using both. Nicotine use of patients with schizophrenia may be ignored by the clinicians. The frequency of nicotine use among patients with schizophrenia is reported to be 58-90%, 2.5-4.5-fold the rate of the general population in the USA. A study from Turkey showed that 50% of patients with schizophrenia are using nicotine and 31% of them are heavy smokers. Different from the world literature, the prevalence of nicotine use is similar to that found in studies based on the general population in Turkey . Alcohol use prevalence is reported as 44.9% while alcohol use disorders prevalence is reported as 8.2% and marijuana use disorder as 2%.
Methods: The study comprised 156 outpatients with diagnosis of schizophrenia. Demographic characteristics of patients, nicotine, alcohol, and drug use were evaluated. Chi-square and t-tests are used for the statistical analysis.
Results: 59.6% (93) of patients were male and 40.4% (63) patients were female. Mean age was calculated as 34.96±11.95. 53.8% (84) of patients reported nicotine use. Nicotine use prevalence among male patients was 73.1% (68) while it was 25.4% (16) in female patients. Alcohol or drug use rate was 18.6%. The alcohol use rate was 13.5% and marijuana use was 5.1%. Prevalence of alcohol use in female patients was 1.6% while it was 21.5% for male patients. Marijuana use was reported by only male patients.
Conclusion: Results of our study are similar to other studies in terms of nicotine use while alcohol use rates in our patient population are lower than in other studies covering outpatients in Turkey. The alcohol use rate was similar to that found in the literature among male patients but significantly lower in female patients. The variety of drugs used was similar to the literature. Nicotine use rates were higher than in the general population for both genders (41.5% vs. 73.1% for males and 13.1% vs. 25.4% for females) and similar to previous studies covering patients with schizophrenia. It is interesting that the general decline of smoking rates in Turkey does not include patients with schizophrenia. In conclusion, our results emphasize the importance of actions for preventing and treating alcohol and drug-use disorders (including nicotine use disorder) in this patient group.