title: Substance abuse and the onset of schizophrenia.
abstract: Up to 60% of chronic schizophrenic patients are reported to abuse alcohol or drugs. This comorbidity raises the question whether one disorder is a consequence of the other. With the structured interview "IRAOS," the onset and course of schizophrenia and substance abuse were retrospectively assessed in a representative first-episode sample of 232 schizophrenic patients. Information by relatives validated the patients' reports. Alcohol abuse prior to first admission was found in 24%, drug abuse in 14%-twice the rates in the general population. Alcohol abuse more often followed than preceded the first symptom of schizophrenia. Drug abuse preceded the first symptom in 27.5%, followed it in 37.9%, and emerged within the same month in 34.6% of the cases. The study demonstrates a remarkable association between first-episode schizophrenia and substance abuse, but a unidirectional causality is not supported, nor is a specific psychotic disorder in comorbid cases.
authors.affiliation: Central Institute of Mental Health, Mannheim, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hambrecht
authors.forename: H
authors.initials: H
authors.lastname: Häfner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000428:Alcohol Drinking / Q000523:psychology; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology*