Influence of alcoholism on the prognosis of schizophrenic patients.

OBJECTIVE

This study was undertaken to investigate possible differences in clinical, social and hospital prognosis in schizophrenics with or without codiagnosed alcoholism.

METHOD

A representative sample was selected by a two-stage random sample of sets from the total of 10,569 schizophrenic patients registered in the Croatian Psychotic Case Register in the period 1962-71. The resulting 449 schizophrenic patients were psychiatrically examined in 1973-75 wherever they were found--at home, in a hospital or in a social-health institution. Of these original patients, 312 with or without a dual diagnosis of schizophrenia and alcoholism who were found at home were followed up until the final examination in 1990-91.

RESULTS

Rate changes in 37 patients with the dual diagnosis were significant in the following characteristics: they were more often men, married, with a paranoid-hallucinatory disease form, were aggressive during examination, and were without psychiatric aftercare or regular psychopharmacotherapy (p < .01); they came from rural areas, had a mixed clinical picture with a deteriorating disease course and were less communicative and socially functional, and were without work self-initiative and personal income (p < .05).

CONCLUSIONS

Schizophrenic patients found at home with codiagnosed alcoholism have poorer clinical, hospital, social and life prognosis and need longer hospitalization. They represent a special subgroup of schizophrenics requiring special therapeutic approach and early identification, inasmuch as their course of the disease has a tendency toward rapid deterioration. Prevention of alcoholism and its adequate treatment have far reaching implications for the prognosis of schizophrenic illness.