Cantor-Graae E, Nordström L G, McNeil T F
Department of Community Medicine, Lund University, University Hospital in Malmö, S-20502, Malmö, Sweden.
Schizophr Res. 2001 Mar 1;48(1):69-82. doi: 10.1016/s0920-9964(00)00114-6.
The purpose of the current study is twofold: (a) to provide an overall synthesis of recent research on substance abuse in schizophrenia and (b) to present findings in a Swedish patient sample. Studies conducted since 1990 have found a wide range of abuse prevalence rates, with male gender and younger age as primary correlates. Less certainty exists regarding substance abuse as an independent risk factor for schizophrenia and its further impact on illness course. In a sample of 87 patients attending a psychiatric clinic in Malmö, lifetime prevalence of substance abuse was 48.3%, with abuse debut primarily preceding first contact for psychotic symptoms. Significant correlates of abuse were male gender, family history of substance abuse, and increased rates of hospitalization and criminality, with poorer outcome found in previous as well as current abusers. Alcohol abuse, either solely or in combination with other substances, was the main type of substance abuse. Although the specific factors (social, behavioural, genetic) that predispose schizophrenic patients to substance abuse remain unclear, the predominantly male profile of abusers might suggest a link between substance abuse and the poorer clinical outcome frequently observed, especially in male schizophrenic patients.
（a）对近期关于精神分裂症中物质滥用的研究进行全面综述；（b）展示瑞典患者样本的研究结果。自1990年以来开展的研究发现了广泛的滥用流行率，其中男性和较年轻年龄是主要相关因素。关于物质滥用作为精神分裂症的独立危险因素及其对病程的进一步影响，存在较少的确定性。在马尔默一家精神病诊所就诊的87名患者样本中，物质滥用的终生患病率为48.3%，滥用首次出现主要先于首次因精神病症状就诊。滥用的显著相关因素为男性、物质滥用家族史、住院率和犯罪率增加，既往及当前滥用者的结局较差。酒精滥用，无论是单独滥用还是与其他物质联合滥用，都是物质滥用的主要类型。尽管导致精神分裂症患者物质滥用的具体因素（社会、行为、遗传）尚不清楚，但滥用者以男性为主的特征可能表明物质滥用与经常观察到的较差临床结局之间存在联系，尤其是在男性精神分裂症患者中。
