title: Substance use in severe mental illness: self-medication and vulnerability factors.
abstract: The aim of this article is to examine the onset and clinical correlates of substance use in patients with psychotic disorders. One hundred and eight inpatients and outpatients with DSM-IV psychotic disorders were evaluated with the SCI-SUBS, an instrument designed to explore the spectrum of substance use and its clinical correlates. Comparisons were made between subjects with (n=47) and without (n=61) a DSM-IV diagnosis of substance use disorder (SUD). In patients with an early onset of psychosis (<17 years), the onset of SUD was subsequent. Patients with SUD had higher substance sensitivity, higher sensation-seeking traits and were more likely to self-medicate than patients without SUD. The reasons for self-medication endorsed by patients with SUD included relieving depression, achieving or maintaining euphoria, improving self-confidence and social abilities. Our results, based on a cross-sectional study, suggest that early onset of psychosis, substance sensitivity and sensation-seeking traits represent vulnerability factors for SUD. The relationships between SUD and psychosis should be examined systematically and clarified in longitudinal studies.
authors.affiliation: Servizio per le Dipendenze, Azienda Sanitaria di Bolzano, Bolzano, Italy. jacopo.bizzarri@asbz.it
authors.forename: Jacopo Vittoriano
authors.initials: JV
authors.lastname: Bizzarri
authors.forename: Paola
authors.initials: P
authors.lastname: Rucci
authors.forename: Alfredo
authors.initials: A
authors.lastname: Sbrana
authors.forename: Mario
authors.initials: M
authors.lastname: Miniati
authors.forename: Federica
authors.initials: F
authors.lastname: Raimondi
authors.forename: Laura
authors.initials: L
authors.lastname: Ravani
authors.forename: Guido Jacopo
authors.initials: GJ
authors.lastname: Massei
authors.forename: Francesca
authors.initials: F
authors.lastname: Milani
authors.forename: Marta
authors.initials: M
authors.lastname: Milianti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Massei
authors.forename: Chiara
authors.initials: C
authors.lastname: Gonnelli
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Cassano
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005106:Exploratory Behavior; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007558:Italy; D008297:Male; D009042:Motivation; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D012559:Schizophrenia / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012651:Self Medication / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
chemical_list: D013287:Illicit Drugs