Chakraborty Rudraprosad, Chatterjee Arunima, Chaudhury Suprakash
Berhampore Mental Hospital, Murshidabad, West Bengal, Berhampore 742101, India.
Pravara Institute of Medical Sciences (Deemed University), Rural Medical College, District of Ahmednagar, Loni, Maharashtra 413736, India.
Psychiatry J. 2014;2014:280243. doi: 10.1155/2014/280243. Epub 2014 Apr 2.
The aim of the present study was to compare a cohort of schizophrenia patients with substance use disorder (SUD) with a similar cohort of schizophrenia patients without SUD with regard to sociodemographic variables, clinical variables, psychopathology, anxiety symptoms, depressive symptoms, treatment outcome, and side effect profile of drugs. A total of 143 consecutive inpatients with ICD-10 DCR diagnosis of schizophrenia were included after obtaining informed consent. Patients were evaluated by a semistructured data sheet and Maudsley Addiction Profile. They were then rated by Positive and Negative Symptoms Scale, Calgary Depression Scale, Hamilton Anxiety Rating Scale, and Brief Psychiatric Rating Scale at presentation, three weeks, and six weeks. At three weeks and six weeks, they were also evaluated by UKU Side Effect Rating Scale. Substance abuse was detected in 63.6% schizophrenia patients. Nicotine was the commonest substance followed by cannabis and alcohol. Substance users had longer untreated illness and more depressive symptoms at presentation and six-week follow-up. Dual diagnosis patients had difficulty in abstraction at three and six weeks but not at presentation. Schizophrenia patients with SUD had more depressive symptoms. SUD appeared to mask abstraction difficulties at presentation. Schizophrenia patients with SUD should be carefully assessed for presence of depression.
本研究的目的是比较一组患有物质使用障碍（SUD）的精神分裂症患者与一组无SUD的类似精神分裂症患者在社会人口统计学变量、临床变量、精神病理学、焦虑症状、抑郁症状、治疗结果及药物副作用方面的情况。在获得知情同意后，纳入了143例连续的符合ICD - 10 DCR诊断标准的精神分裂症住院患者。患者通过一份半结构化数据表和莫兹利成瘾量表进行评估。随后，在入院时、三周及六周时分别采用阳性和阴性症状量表、卡尔加里抑郁量表、汉密尔顿焦虑评定量表及简明精神病评定量表进行评分。在三周及六周时，还采用UKU副作用评定量表对患者进行评估。63.6%的精神分裂症患者被检测出存在物质滥用情况。尼古丁是最常见的物质，其次是大麻和酒精。物质使用者在入院时及六周随访时的未治疗病程更长，抑郁症状更多。双重诊断患者在三周及六周时存在抽象思维困难，但入院时不存在。患有SUD的精神分裂症患者抑郁症状更多。SUD似乎在入院时掩盖了抽象思维困难。对于患有SUD的精神分裂症患者，应仔细评估其是否存在抑郁。
