title: Comorbid substance use disorder in schizophrenia: a selective overview of neurobiological and cognitive underpinnings.
abstract: Although individuals with schizophrenia show a lifetime prevalence of 50% for suffering from a comorbid substance use disorder, substance abuse usually represents an exclusion criterion for studies on schizophrenia. This implies that surprisingly little is known about a large group of patients who are particularly difficult to treat. The aim of the present work is to provide a brief and non-exhaustive overview of the current knowledgebase about neurobiological and cognitive underpinnings for dual diagnosis schizophrenia patients. Studies published within the last 20 years were considered using computerized search engines. The focus was on nicotine, caffeine, alcohol, cannabis and cocaine being among the most common substances of abuse. All drugs of abuse target dopaminergic, glutamatergic and GABAergic transmission which are also involved in the pathophysiology of schizophrenia. Current literature suggests that neurocognitive function might beless disrupted in substance-abusing compared to non-abusing schizophrenia patients, but in particular the neuroimaging database on this topic is sparse. Detrimental effects on brain structure and function were shown for patients for whom alcohol is the main substance of abuse. It is as yet unclear whether this finding might be an artifact of age differences of patient subgroups with different substance abuse patterns. More research is warranted on the specific neurocognitive underpinnings of schizophrenia patients abusing distinct psychoactive substances. Treatment programs might either benefit from preserved cognitive function as a resource or specifically target cognitive impairment in different subgroups of addicted schizophrenia patients.
authors.affiliation: Department of Neuropsychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany. patrizia.thoma@rub.de
authors.forename: Patrizia
authors.initials: P
authors.lastname: Thoma
authors.forename: Irene
authors.initials: I
authors.lastname: Daum
mesh_terms: D000437:Alcoholism / Q000523:psychology; D001921:Brain / Q000473:pathology; D002110:Caffeine / Q000494:pharmacology; D000697:Central Nervous System Stimulants / Q000494:pharmacology; D003071:Cognition / Q000502:physiology*; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D002189:Marijuana Abuse / Q000523:psychology; D018377:Neurotransmitter Agents / Q000378:metabolism; D009538:Nicotine / Q000494:pharmacology; D018722:Nicotinic Agonists / Q000494:pharmacology; D012559:Schizophrenia / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D012565:Schizophrenic Psychology; D012931:Social Environment; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology
chemical_list: D000697:Central Nervous System Stimulants; D018377:Neurotransmitter Agents; D018722:Nicotinic Agonists; D002110:Caffeine; D009538:Nicotine
keywords: alcohol; cannabis; cocaine; dual diagnosis schizophrenia; substance use disorder