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Schizophrenia and Other Psychotic Disorders

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Drug Abuse and Addiction in Medical Illness

Abstract

Around half of all people with psychosis have a co-occurring substance use problem, a much higher prevalence rate than that found in the general population. Alcohol and cannabis are the most frequently used substances, and multiple substance use is common. This comorbidity has profound implications for the course and treatment of psychotic disorders. People with psychosis who use drugs and alcohol have been reported to have poorer symptomatic and functional outcomes than their non-substance using counterparts: they experience more symptoms, are less likely to be compliant with medication, are at greater risk of relapse and hospitalisation and as a consequence make greater use of mental health services. The causes of this increased comorbidity are not yet fully understood. There is evidence that cannabis may act as a specific trigger for psychosis in some vulnerable individuals but simple broad models of either substance use causing schizophrenia or schizophrenia causing substance use have largely been discredited. Multiple risk factor models of comorbidity have not been adequately tested. Research on treatment development is limited and the findings contradictory: there is preliminary evidence for Clozapine but no evidence to support any one atypical antipsychotic over another. Likewise, despite promising findings for a combination of motivational interviewing and cognitive behavioural therapy there is little evidence for its superiority when compared to other psychosocial interventions. More good-quality longitudinal research is needed.

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Authors and Affiliations

  1. Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, Brunswick Street, Manchester, UK

    L. Gregg

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  1. L. Gregg
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Correspondence to L. Gregg .

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Editors and Affiliations

  1. Inst. Pharmaceutical Sciences, Department of Psychopharmacology, Utrecht University, Universiteitsweg 99, Utrecht, 3584CG, Netherlands

    Joris C. Verster

  2. Dept. Psychiatry, Medical University of South Carolina, President St. 67, Charleston, 29425, South Carolina, USA

    Kathleen Brady

  3. School of Medicine, Div. Alcoholism & Drug Abuse, New York University, First Ave. 550, New York, 10016, New York, USA

    Marc Galanter

  4. Institute of Psychiatry, King's College London, National Addiction Centre, Windsor Walk 4, London, SE5 8AF, United Kingdom

    Patricia Conrod

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Gregg, L. (2012). Schizophrenia and Other Psychotic Disorders. In: Verster, J., Brady, K., Galanter, M., Conrod, P. (eds) Drug Abuse and Addiction in Medical Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3375-0_25

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  • DOI: https://doi.org/10.1007/978-1-4614-3375-0_25

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