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首页> 外文期刊>Clinical practice and epidemiology in mental health >Substance abuse in first-episode schizophrenic patients: a retrospective study
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Substance abuse in first-episode schizophrenic patients: a retrospective study

机译：首发精神分裂症患者的药物滥用：一项回顾性研究

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Several studies suggest a high comorbidity of substance abuse and schizophrenia, associated with higher frequency of relapse, more positive symptoms and depression, cognitive impairment, poorer outcome and treatment response. A high incidence of substance abuse is also observed in first-episode patients. Among patients with substance abuse, the onset precedes the onset of psychosis of several years in most cases. All the patients with a first episode of schizophrenia, at first admission to the Psychiatric Service of Diagnosis and Treatment of Ospedale Maggiore of Milan during the years 1990 to 2004, have been included in our study. The clinical evaluation has been obtained considering the following items of Brief Psychiatric Rating Scale (BPRS): conceptual disorganization, depressed mood, hostility, hallucinations, unusual content of thought. The results showed that 34.7% of first-episode schizophrenic patients had a lifetime history of substance abuse. The age of onset of schizophrenia is significantly lower for drug abusers than for patients without any type of abuse and for alcohol abusers (p < 0.005). In multi drug abusers, cannabis resulted the most frequently used (49%), followed by alcohol (13%), and cocaine (4%). Substance abusers have obtained a significant higher score in "thought disturbance" item (p < 0.005) and in "hostility" item (p < 0.005) compared to non substance abusers. Non drug abusers showed lower mean scores of "hostility" item compared to cocaine abusers and multi drug abusers (p < 0.005). Our findings seem to indicate that substance abuse in the early course of illness determines an earlier onset of schizophrenia and increases severity of some psychotic symptoms like "hallucination" and "unusual content of thought". Therefore persons incurring a risk of schizophrenia may be warned of the possible relation between substances and psychosis and have to be counselled against the use of them.
机译：几项研究表明，药物滥用和精神分裂症合并症较高，与复发频率更高，症状和抑郁症状更积极，认知障碍，预后和治疗反应较差有关。在首发患者中也观察到了药物滥用的高发生率。在大多数情况下，在滥用药物的患者中，其发病要先于精神病发作数年。在1990年至2004年期间首次进入米兰精神病诊断与治疗精神病科的所有精神分裂症首发患者均已纳入我们的研究。考虑到以下简短的精神病学评定量表（BPRS），获得了临床评估：概念混乱，情绪低落，敌意，幻觉，异常的思想内容。结果显示34.7％的首发精神分裂症患者终生有药物滥用史。药物滥用者的精神分裂症发病年龄明显低于没有任何类型的滥用者和酒精滥用者（p <0.005）。在吸毒者中，大麻是最常用的药物（49％），其次是酒精（13％）和可卡因（4％）。与非药物滥用者相比，药物滥用者在“思想障碍”项目（p <0.005）和“敌意”项目（p <0.005）中获得了明显更高的分数。与可卡因滥用者和多种药物滥用者相比，非药物滥用者表现出的“敌意”项目平均得分较低（p <0.005）。我们的发现似乎表明，在疾病的早期阶段滥用药物决定了精神分裂症的更早发作，并加剧了某些精神病性症状的严重性，例如“晕眩”和“思想异常”。因此，可能警告患有精神分裂症风险的人药物与精神病之间可能存在的联系，并应劝告他们不要使用这些物质。

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