Temmingh Henk S, Mall Sumaya, Howells Fleur M, Sibeko Goodman, Stein Dan J
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Psychiatr. 2020 Jul 28;26:1473. doi: 10.4102/sajpsychiatry.v26i0.1473. eCollection 2020.
Substance use disorders (SUDs) occur frequently in patients with psychotic disorders and have been associated with various demographic and clinical correlates. There is an absence of research on the prevalence and clinical correlates of SUDs in psychotic disorders in low-and-middle-income countries (LMICs).
We aimed to determine the prevalence and correlates of SUDs in psychotic disorders.
Patients attending a large secondary-level psychiatric hospital in Cape Town South Africa.
We used the Structured Clinical Interview for DSM-IV (SCID-I) to determine psychiatric and substance use diagnoses, depressive, anxiety, obsessive-compulsive and post-traumatic symptoms. We used logistic regression models to determine significant predictors of SUDs.
In total sample ( = 248), 55.6% of participants had any SUD, 34.3% had cannabis use disorders, 30.6% alcohol use disorders, 27.4% methamphetamine use disorders, 10.4% methaqualone use disorders and 4.8% had other SUDs. There were significant associations with male sex for most SUDs, with younger age and Coloured ethnicity for methamphetamine use disorders, and with lower educational attainment for cannabis use disorders. Anxiety symptoms and suicide attempts were significantly associated with alcohol use disorders; a diagnosis of a substance induced psychosis with cannabis and methamphetamine use disorders. Across most SUDs legal problems and criminal involvement were significantly increased.
This study found a high prevalence and wide distribution of SUDs in patients with psychotic disorders, consistent with previous work from high income countries. Given clinical correlates, in individuals with psychotic disorders and SUDs it is important to assess anxiety symptoms, suicidality and criminal involvement.
物质使用障碍（SUDs）在精神障碍患者中频繁出现，并与各种人口统计学和临床相关因素有关。中低收入国家（LMICs）精神障碍中物质使用障碍的患病率及临床相关因素的研究尚属空白。
我们旨在确定精神障碍中物质使用障碍的患病率及相关因素。
南非开普敦一家大型二级精神病医院的患者。
我们使用《精神疾病诊断与统计手册》第四版结构化临床访谈（SCID-I）来确定精神疾病和物质使用诊断、抑郁、焦虑、强迫和创伤后症状。我们使用逻辑回归模型来确定物质使用障碍的显著预测因素。
在总样本（n = 248）中，55.6%的参与者患有任何物质使用障碍，34.3%患有大麻使用障碍，30.6%患有酒精使用障碍，27.4%患有甲基苯丙胺使用障碍，10.4%患有甲喹酮使用障碍，4.8%患有其他物质使用障碍。大多数物质使用障碍与男性性别显著相关，甲基苯丙胺使用障碍与较年轻年龄和有色人种相关，大麻使用障碍与较低教育程度相关。焦虑症状和自杀未遂与酒精使用障碍显著相关；物质所致精神病的诊断与大麻和甲基苯丙胺使用障碍相关。在大多数物质使用障碍中，法律问题和犯罪参与显著增加。
本研究发现精神障碍患者中物质使用障碍的患病率很高且分布广泛，这与高收入国家以前的研究结果一致。鉴于临床相关因素，对于患有精神障碍和物质使用障碍的个体，评估焦虑症状、自杀倾向和犯罪参与情况很重要。
