Ross Stephen, Peselow Eric
Division of Alcoholism and Drug Abuse, Department of Psychiatry, Bellevue Hospital Center, New York, NY 10016, USA.
Clin Neuropharmacol. 2012 Sep-Oct;35(5):235-43. doi: 10.1097/WNF.0b013e318261e193.
Psychosis and substance abuse are intimately related. Psychotic spectrum illnesses commonly co-occur with substance use disorders (SUDs), and many substances of abuse can cause or exacerbate psychotic symptoms along a temporal spectrum from acute to chronic presentations. Despite the common co-occurrence between psychotic spectrum illnesses and SUDs, they are often under-recognized and undertreated, leading to poor treatment outcomes. Accurate detection and diagnosis of individuals with psychotic illness co-occurring with addictive disorders is key to properly treat such disorders. This article will review the nature of the relationship between psychosis and substance abuse by examining prevalence rates of each disorder alone and their rates of co-occurrence, the neurobiological basis for substance abuse comorbidity in schizophrenia spectrum disorders, key and salient aspects related to accurate diagnosis along a continuum from acute to subacute to chronic conditions, and pitfalls associated with diagnostic dilemmas. A case example will be used to highlight key points related to diagnostic challenges.
精神病与药物滥用密切相关。精神病性谱系疾病通常与物质使用障碍（SUDs）同时出现，许多滥用物质可在从急性到慢性表现的时间范围内导致或加重精神病症状。尽管精神病性谱系疾病和物质使用障碍经常同时出现，但它们往往未得到充分认识和治疗，导致治疗效果不佳。准确检测和诊断患有精神病性疾病且同时患有成瘾性障碍的个体是妥善治疗此类疾病的关键。本文将通过研究每种疾病单独的患病率及其共病率、精神分裂症谱系障碍中物质滥用共病的神经生物学基础、从急性到亚急性再到慢性疾病连续过程中与准确诊断相关的关键和显著方面以及与诊断困境相关的陷阱，来综述精神病与药物滥用之间关系的本质。将通过一个案例来突出与诊断挑战相关的要点。
