Substance use among patients with schizophrenia in a university hospital

Objective: Individuals with schizoprenia are known to be at increased risk for comorbid substance use disorders compared to the general population. The aim of the study was to identify the prevalence of substance use and abuse among a group of patients with schizophrenia.

Methods: Forty-nine schizophrenic patients were assessed with Structured Clinical Interview for DSM IV Axis I Disorders (SCID-I) for schizophrenia and substance use disorders. Demographic and clinical characteristics were investigated in a semistructured interview. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale (CGI), Hamilton Depression Scale (HAMD) were used to evaluate the psychiatric symptomatology, and Extrapyramidal Symptom Rating Scale (ESRS) for extrapyramidal side effects. Fagerström Nicotine Tolerance Questionnaire was used for the severity of nicotine dependence. The CAGE Questionnaire and Alcohol Use Disorders Identification Test (AUDIT) were used for screening alcohol related problems.

Results: The prevalence of current cigarette smoking was 69.4%. The prevalence of current alcohol use was 44.9%, 8.2% were considered to be alcohol abusers. Only one patient (2%) diagnosed as cannabis abuse. Demographic and clinical characteristics were not found to be significantly associated with cigarette and alcohol use. While the prevalence of cigarette smoking in patients with schizophrenia was high, the prevalence of alcohol and cannabis use was low compared to other countries.

Conclusion: We conclude that the high level of family support and/or a low prevalence of alcohol and substance use among general population together with non-availability of illicit substances may account for these findings.