Substance use in severe mental illness: self-medication and vulnerability factors.
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.
Bizzarri
Jacopo Vittoriano
JV
Servizio per le Dipendenze, Azienda Sanitaria di Bolzano, Bolzano, Italy. jacopo.bizzarri@asbz.it
Rucci
Paola
P
Sbrana
Alfredo
A
Miniati
Mario
M
Raimondi
Federica
F
Ravani
Laura
L
Massei
Guido Jacopo
GJ
Milani
Francesca
F
Milianti
Marta
M
Massei
Gabriele
G
Gonnelli
Chiara
C
Cassano
Giovanni Battista
GB
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
D013287:Illicit Drugs