Substance Misuse Among Patients Having Schizophrenia and Its Effect on Their Clinical and Functional Status

Objective: Substance misuse is the most common co-morbid problem among schizophrenic patients which results in frequent relapses, high positive symptoms, cognitive impairment and poor outcome. The aim of the study was to examine the prevalence of substance misuse among patients having schizophrenia and its effect on their clinical and functional status. Methods: In a cross sectional survey, 120 adult patients diagnosed with schizophrenia and their family members in out patient psychiatry clinic of AIIMS, New Delhi were selected conveniently. Socio-demographic Schedule, Clinical Profile Sheet, Mini-International Neuropsychiatric Interview (MINI), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Positive and Negative Syndrome Scale (PANSS) and Disability Assessment Schedule II (WHODAS II ) were used to collect data. Results: Half (49.1%) of patients were current substance users with nearly one third (30%) poly substances users. The most common substances misused were nicotine, alcohol and cannabis. A little over half (54%) of current users were dependent or at high risk. Most of current substance users were male, paid worker, stayed in rural area, had late age of onset of schizophrenia, irregular with follow up and non-complaint to their psychiatric treatment regimen. No difference was found in never, past and current substance users on PANSS subscales. Difficulty in abstract thinking and poor impulse control was found in current substance users with good physical and social functioning. Conclusions: High substance misuse was found among schizophrenic patients. The potential effect of substance misuse identifies in this study may be helpful for designing and implementing preventive and corrective measurers. Please click PDF below to download the full paper...