Jiménez-Castro Lorena, Raventós-Vorst Henriette, Escamilla Michael
Department of Cellular and Structural Biology University of Texas Health Science Center at San Antonio San Antonio, TX 78229, USA.
Actas Esp Psiquiatr. 2011 Mar-Apr;39(2):123-30. Epub 2011 Mar 1.
Interest in understanding the comorbidity of schizophrenia and substance use disorder has been increasing due to the increase of this diagnosis, to the negative effects observed in the subject and to the health service costs. This dual disorder can have dramatic effects on the clinical course of the psychiatric disorder, this being, for example increased relapses, re-hospitalizations, more severe symptoms, noncompliance with antipsychotic medication, marked mood changes, increased rates of hostility and suicidal ideation as well as in other areas of functioning, including interpersonal violence and victimization, homelessness, and legal problems. Literature from the United States and Europe in particular suggests that the prevalence rates for this dual diagnosis may range from 10 to 70%. In this study, we have reviewed the prevalence of the dual diagnosis of schizophrenia and substance use disorder as well as the sociodemographic characteristics in the literature on Latin-American populations. Notwithstanding that the dual disorder is a widely accepted diagnosis, relatively little is known about its prevalence in Latin American populations or about the environmental factors that may influence it, as well as about the demographic, clinical, and other characteristics of these individuals. A better understanding of this diagnosis might improve the methods for the detection and assessment of substance use disorder in persons with severe mental illness such as schizophrenia.
由于精神分裂症与物质使用障碍共病的诊断病例增多、观察到的对患者的负面影响以及医疗服务成本增加，人们对理解这两种疾病的共病情况的兴趣一直在上升。这种双重障碍会对精神疾病的临床病程产生巨大影响，例如导致复发增加、再次住院、症状更严重、不遵医嘱服用抗精神病药物、情绪显著变化、敌意和自杀意念发生率上升，以及在包括人际暴力和受害、无家可归和法律问题等其他功能领域出现问题。特别是来自美国和欧洲的文献表明，这种双重诊断的患病率可能在10%至70%之间。在本研究中，我们回顾了拉丁美洲人群文献中精神分裂症与物质使用障碍双重诊断的患病率以及社会人口学特征。尽管双重障碍是一种被广泛认可的诊断，但对于其在拉丁美洲人群中的患病率、可能影响它的环境因素，以及这些个体的人口统计学、临床和其他特征，人们了解得相对较少。更好地理解这种诊断可能会改进对患有严重精神疾病（如精神分裂症）的患者进行物质使用障碍检测和评估的方法。
