Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 10, 8000 Aarhus C, Denmark.
Psychiatric Research Unit, Psychiatry Region Zealand, Toftebakken 9, 4000 Roskilde, Denmark; Institute of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
Schizophr Res. 2018 May;195:495-500. doi: 10.1016/j.schres.2017.09.026. Epub 2017 Sep 29.
Patients with schizophrenia and comorbid drug use disorders (DUD) have a severe course of illness. Despite strong evidence that drug use can exacerbate psychotic symptoms, we have limited knowledge of how specific drugs may increase risk of schizophrenia readmission in this group. This study aimed to assess drug-related predictors of readmission for schizophrenia among a national cohort of patients with a history of schizophrenia admitted to DUD treatment.
A record-linkage study was used to assess drug-related factors associated with readmission to mental health treatment for schizophrenia, using a consecutive cohort of 634 patients admitted to DUD treatment between 2000 and 2006 in Danish treatment services and tracked until February 2013 or death, controlling for baseline psychiatric treatment variables.
The majority of patients were males (79.8%) and the mean age was 34.7years. Of all patients, 78.7% were readmitted for schizophrenia during follow-up, and 6.8% died without having been readmitted. We found a robust association between use of amphetamine at baseline and elevated risk of readmission, a less robust association between use of cannabis and elevated risk of readmission, and no association with cocaine, opioids, alcohol, benzodiazepines, and MDMA. Furthermore, one or more psychiatric inpatients visit in the year prior to DUD admission was robustly associated with elevated risk of schizophrenia readmission.
Use of amphetamine and cannabis are risk markers for schizophrenia readmission among patients with a history of schizophrenia and DUD. Psychiatric history is a predictor of schizophrenia readmission in this patient group.
患有精神分裂症和合并药物使用障碍（DUD）的患者病情严重。尽管有强有力的证据表明药物使用会加重精神病症状，但我们对特定药物如何增加该人群精神分裂症再入院的风险知之甚少。本研究旨在评估在有精神分裂症病史的患者接受 DUD 治疗的全国队列中，与药物相关的因素对精神分裂症再入院的预测作用。
使用记录链接研究评估与精神分裂症再入院相关的药物相关因素，该研究使用了 2000 年至 2006 年间丹麦治疗服务机构中连续收治的 634 名患有 DUD 的患者队列，这些患者一直跟踪随访至 2013 年 2 月或死亡，同时控制了基线精神科治疗变量。
大多数患者为男性（79.8%），平均年龄为 34.7 岁。在所有患者中，78.7%在随访期间因精神分裂症再次入院，6.8%在没有再次入院的情况下死亡。我们发现，基线时使用安非他命与再入院风险增加之间存在强有力的关联，而使用大麻与再入院风险增加之间的关联较弱，与可卡因、阿片类药物、酒精、苯二氮䓬类药物和摇头丸之间无关联。此外，DUD 入院前一年中一次或多次住院的精神科就诊与精神分裂症再入院的风险增加显著相关。
在患有精神分裂症和 DUD 的患者中，使用安非他命和大麻是精神分裂症再入院的风险标志物。在该患者群体中，精神病史是精神分裂症再入院的预测因素。
