Schizophrenia and co-occurring substance use disorder.

摘要

This patient presents with a "dual disorder," most likely schizophrenia and co-occurring alcohol and cannabis use disorders. This is not an uncommon clinical scenario. The literature suggests that nearly 50% of patients with schizophrenia have a co-occurring substance use disorder, most frequently alcohol and/or cannabis (at a rate about three times as high as that of the general population) [1). Patients with dual diagnoses are highly prone to adverse outcomes in several domains: increased symptom severity; increased rates of hospitalization, infectious illnesses, violence, victimization, homelessness, and nonadherence to medication; and poor overall response to pharmacologic treatment (1). Co-occurring substance use disorders contribute substantially to the financial costs and emotional burdens of schizophrenia-for patients, their families, and the mental health system.