The Comorbidity Of Schizophrenia And Alcohol: From Cognitive Destruction To Social Isolation (original) (raw)
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Objectives As the available studies suggest, inconsistently, that alcoholabuse may be associated with greater cognitive impairment in schizophrenia patients, we compared cognitive functioning among matched schizophrenia patients with and without comorbid alcohol abuse, and matched healthy controls. Methods We applied the Milan Overall Dementia Assessment (MODA) cognitive test battery to compare cognitive functioning in patients with schizophrenia meeting DSM-IV criteria with (n = 17) or without (n = 40) lifetime alcohol abuse, verified with the Michigan Alcohol Screening Test (MAST), and patients versus healthy controls (n = 21) matched for age, sex, education and psychosis ratings. Results Cognitive performance was greatly impaired in both patientgroups compared to healthy controls, but only 6.2% more among patients with than without a history of alcohol-abuse. MODA and MAST scores were highly and inversely correlated. Conclusions Cognitive functioning in schizophrenia patients was substantially lower than in healthy subjects, as expected, but only slightly more impaired with a lifetime history of alcohol abuse.
Schizophrenia Research, 2001
Objective: To identify correlates of self-reported substance use and problems associated with that use in people with schizophrenia. Methods: A sample of 404 patients with schizophrenia, schizoaffective disorder, or schizophreniform disorder and longitudinal assessments of substance use were examined. Three groups were formed according to consistency of substance use over time: No/Low Alcohol, Alcohol Only, and Drug Use (with or without alcohol use). Similar groups were formed regarding problems associated with alcohol use. Groups were compared on demographics, psychiatric history, psychopathology, medication side effects, and social functioning. Results: Substance users were more likely to be young, male, and to have lower levels of education. Substance users generally had fewer negative symptoms, more social contacts, and better socialleisure functioning. However, substance users, especially drug users, also were rated as having more interpersonal and family problems, had an earlier age at ®rst psychiatric hospitalization, and were more likely to have been recently hospitalized. Patients reporting problems with alcohol use reported more frequent alcohol and drug use, greater severity of akathisia, and problems in interpersonal, family, and self-ef®cacy domains. Conclusions: Many of the same variables that correlate with substance use disorder also correlated with moderate substance use in this sample of people with schizophrenia. Although moderate users of alcohol and drugs may have better social functioning in some areas, they also are likely to have substantial problems in interpersonal relationships, especially those involving family members. q
Alcohol Use and Alcoholism Among Individuals with Schizophrenia in the North of Iran
Iranian Journal of Psychiatry and Behavioral Sciences
Background: Alcohol consumption is one of the most common problematic issues globally that usually causes high costs for the health system. Also, schizophrenia is a chronic psychiatric disorder responsible for a heavy burden on healthcare providers. Objectives: This study aimed to investigate alcohol use and alcoholism in schizophrenia in Iran. Methods: A cross-sectional (descriptive-analytical) study was conducted on 400 individuals with schizophrenia referred to the psychiatry hospital of Mazandaran University of Medical Sciences. History of alcohol consumption and the criteria of alcohol use disorder according to DSM-5-TR were sought during the interviews using the Alcohol Use Disorder Identification Test (AUDIT). Results: Of the patients, 45.5% had drunk alcohol at some point in their lives, 23% had low-risk alcohol consumption, and 10% experienced high-risk consumption. In addition, 1.5% of our sample suffered from alcoholism, according to the AUDIT. Conclusions: The results of...
Alcohol Use Disorder and Schizophrenia and Schizoaffective� Disorders
Alcohol Research: Current Reviews, 2019
Schizophrenia and schizoaffective disorder are schizophrenia spectrum disorders that cause significant disability. Among individuals who have schizophrenia or schizoaffective disorder, alcohol use disorder (AUD) is common, and it contributes to worse outcomes than for those who do not have co-occurring substance use disorder. Common neurobiological mechanisms, including dysfunction in brain reward circuitry, may explain the high rates of co-occurrence of schizophrenia and AUD or other substance use disorders. Optimal treatment combines pharmacologic intervention and other therapeutic modalities to address both the psychotic disorder and AUD. Further research on the etiology of these co-occurring disorders and on treatment of affected individuals is needed.
Aim: The aim of this study is to assess the neuropsychological profiles of chronic schizophrenia and alcohol-dependent subjects. Materials and Methods: This hospital-based cross-sectional study included 30 chronic schizophrenia patients, 30 alcohol-dependent patients and 30-matched normal controls. Demographic and clinical data were collected on a self-designed pro forma. Positive and Negative Syndrome Scale (PANSS) and Severity of Alcohol Dependence Questionnaire (SADQ-C) were administered to chronic schizophrenia and alcohol-dependent patients, respectively. The AIIMS Comprehensive Neuropsychological Battery in Hindi (Adult Form) was used to assess neuropsychological dysfunctions. Results: Neuropsychological dysfunctions were found in 83.3% of chronic schizophrenia patients, 36.7% alcohol dependents and none of the normal subjects. In comparison to normal subjects, schizophrenia patients had significantly more dysfunctions in neuropsychological-domains such as motor, tactile, visual, receptive and expressive speech, reading, writing, arithmetic, memory, and intellectual processes. A significant positive correlation was found between the PANSS total score and T scores of most of the clinical scales except motor and visual scales; the PANSS general psychopathology score and T scores of most of the clinical scales except motor visual and pathognomonic scales; the PANSS negative score and T scores of most of the clinical scales except visual scale; and the PANSS positive score and T scores of receptive speech, arithmetic, and memory scales. In comparison to normal subjects, the alcohol dependents had significantly more dysfunctions in neuropsychological-domains such as motor, tactile, visual, receptive and expressive speech, reading, writing, arithmetic, and memory. A significant positive correlation was found between the SADQ total scale and T scores of clinical scales such as expressive speech, writing, arithmetic, intellectual processes, left hemisphere, and total battery scales. Conclusions: Neuropsychological dysfunction was significantly more common and severe in chronic schizophrenia patients than in alcohol-dependent patients. In comparison to alcohol dependents, the chronic schizophrenia patients had more dysfunctions in neuropsychological-domains such as tactile, arithmetic, memory, and intellectual processes.
The vulnerability to alcohol and substance abuse in individuals diagnosed with schizophrenia
Neurotoxicity Research, 2006
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 duallydiagnosed patient group.