Schizophrenia and substance abuse.
BACKGROUND
Recent research from North America has demonstrated higher than expected rates of drug and alcohol abuse among the seriously mentally ill. Schizophrenics appear to be particularly susceptible to the negative effects of substance abuse. These include psychiatric and social complications, with antisocial behaviour, particularly violence emerging as one of the most worrying features. This review examines the strength of the association and explores the possible explanations for the apparent link between schizophrenia, substance abuse and violence.


METHODS
The literature was searched using Medline, supplemented with a manual literature search.


RESULTS
Very few articles specifically approached the problem of violence among substance abusing schizophrenics, but over 80 papers were identified which were helpful in exploring the link between dangerous behaviour and substance abuse by schizophrenics.


CONCLUSIONS
While there is circumstantial evidence to support the hypothesis that schizophrenics who abuse drugs or alcohol are at an increased risk of behaving violently, longitudinal studies are required to facilitate a better understanding of the mediating mechanisms.
Smith
J
J
Fromeside Clinic, Bristol.
Hucker
S
S
D003131:Combined Modality Therapy; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D011619:Psychotropic Drugs / Q000009:adverse effects; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology* / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D014754:Violence
D013287:Illicit Drugs; D011619:Psychotropic Drugs