Evren E Cüneyt, Evren Bilge
Turk Psikiyatri Derg. 2003 Fall;14(3):213-24.
There is a high alcohol/substance use disorder comorbidity rate in schizophrenia. This article reviews the prevalence of comorbid alcohol-substance use disorders in schizophrenia, methodological problems while examining this topic, etiological models, the impact of alcohol-substance use disorders on course and outcome of schizophrenia and treatment of these comorbid conditions. The literature search was conducted through the Medline records of the National Library of Medicine. The etiology of high prevalence rate of alcohol-substance use disorders in schizophrenia is unclear. There is support for the supersensitivity model which posits that biological vulnerability of psychiatric disorders results in sensitivity to small amounts of alcohol and drugs, leading to substance use disorders. There is minimal support for the self-medication model, but the accumulation of other risk factors, may increase the risk of substance use disorder. While planning the risk prevention, care and treatment of schizophrenic patients, alcohol-substance abuse must also be evaluated. Particularly young male patients, patients who have antisocial personality properties and depressive symptoms must be taken as a group with risk and alcohol-substance use must be evaluated carefully in this population. Relapses, violence and suicide risks must be taken in to account while treatment of these comorbid patients. They must be taken as a different group regarding the treatment and some special interventions must be taken with these patients.
精神分裂症患者中酒精/物质使用障碍的共病率很高。本文综述了精神分裂症中共病酒精-物质使用障碍的患病率、研究该主题时的方法学问题、病因模型、酒精-物质使用障碍对精神分裂症病程和结局的影响以及这些共病情况的治疗。通过美国国立医学图书馆的Medline记录进行文献检索。精神分裂症中酒精-物质使用障碍高患病率的病因尚不清楚。超敏模型得到了支持，该模型认为精神障碍的生物易感性导致对少量酒精和药物敏感，从而导致物质使用障碍。自我药疗模型得到的支持很少，但其他危险因素的累积可能会增加物质使用障碍的风险。在规划精神分裂症患者的风险预防、护理和治疗时，还必须评估酒精-物质滥用情况。特别是年轻男性患者、具有反社会人格特质和抑郁症状的患者必须被视为有风险的群体，必须对该人群的酒精-物质使用情况进行仔细评估。在治疗这些共病患者时，必须考虑复发、暴力和自杀风险。在治疗方面，他们必须被视为一个不同的群体，必须对这些患者采取一些特殊干预措施。
