Kivimies Kristiina, Repo-Tiihonen Eila, Kautiainen Hannu, Maaranen Päivi, Muhonen Leea H, Heikkinen Martti, Tiihonen Jari
a Kristiina Kivimies, Department of Forensic Psychiatry , University of Eastern Finland, Niuvanniemi Hospital , Kuopio , Finland.
b Eila Repo-Tiihonen, Department of Forensic Psychiatry , University of Eastern Finland, Niuvanniemi Hospital , Kuopio , Finland.
Nord J Psychiatry. 2016;70(2):128-32. doi: 10.3109/08039488.2015.1059884. Epub 2015 Aug 27.
Substance abuse worsens the course of schizophrenia, but it is not known whether or not there are differences between specific substances concerning their association with the hospitalizations of patients with schizophrenia.
The primary aims of this study were to examine the possible associations between amphetamine, cannabis, and opioid abuse, and the risk of hospitalizations among patients with schizophrenia.
The study population consisted of 146 patients with ICD-defined schizophrenia from two different geographical sites in Finland, and it included both inpatients and outpatients. Data were collected retrospectively from the patients' medical files. Substance abuse was defined as either harmful use or dependence according to ICD-10.
The cumulative prevalence of substance abuse was 10.9% (16/146) for cannabis, 8.9% (13/146) for amphetamine, and 4.1% (6/146) for opioids. Among patients with schizophrenia and abuse of any substance, the number of hospitalizations was about 1.5-fold when compared to those without substance abuse. The incidence rate ratio for hospitalizations was 2.9 (95% CI 2.47-3.63) for opioids, 2.0 (1.71-2.41) for amphetamine, and 1.6 (1.33-1.84) for cannabis, when compared with no abuse of each substance. The risk of hospitalizations was significantly higher for opioids when compared with amphetamine (p < 0.001) or cannabis (p < 0.001).
Harmful use or dependence of opioids among patients with schizophrenia is associated with significantly higher risk of hospitalizations than either harmful use or dependence of amphetamine or cannabis.
药物滥用会使精神分裂症的病情恶化，但目前尚不清楚特定药物在与精神分裂症患者住院治疗的关联方面是否存在差异。
本研究的主要目的是探讨苯丙胺、大麻和阿片类药物滥用与精神分裂症患者住院风险之间的可能关联。
研究人群包括来自芬兰两个不同地理位置的146例符合国际疾病分类（ICD）定义的精神分裂症患者，包括住院患者和门诊患者。数据通过回顾性方式从患者的医疗档案中收集。根据ICD-10，药物滥用被定义为有害使用或依赖。
大麻的药物滥用累积患病率为10.9%（16/146），苯丙胺为8.9%（13/146），阿片类药物为4.1%（6/146）。在患有精神分裂症且滥用任何药物的患者中，与未滥用药物的患者相比，住院次数约为其1.5倍。与未滥用每种药物相比，阿片类药物滥用患者的住院发病率比为2.9（95%可信区间2.47 - 3.63），苯丙胺为2.0（1.71 - 2.41），大麻为1.6（1.33 - 1.84）。与苯丙胺（p < 0.001）或大麻（p < 0.001）相比，阿片类药物滥用患者的住院风险显著更高。
与苯丙胺或大麻的有害使用或依赖相比，精神分裂症患者中阿片类药物的有害使用或依赖与显著更高的住院风险相关。
