LeDuc P A, Mittleman G
Psychology Department, University of Memphis, TN 38152, USA.
Psychopharmacology (Berl). 1995 Oct;121(4):407-27. doi: 10.1007/BF02246489.
The authors selected articles from those published between 1975 and 1994 that specifically documented psychostimulant abuse in patients determined to be schizophrenic according to recent and relatively uniform diagnostic criteria. These articles indicated that the incidence of psychostimulant abuse in schizophrenics is 2-5 times higher than that of the general public. Additionally, unlike the decline in stimulant use seen in older adults in the general population, high rates of abuse appeared to be maintained in schizophrenics. Although the incidence of abuse in this group was high, comparisons of abuse rates generated by self report with those obtained by urinalysis indicated that the frequency of abuse is being underestimated by 15-21%. Potential factors contributing to stimulant abuse in schizophrenics, including the disease process, and the influence of chronic neuroleptic medication, were evaluated. Results indicated that the incidence of psychostimulant abuse was neither a common property of psychiatric patients, nor exclusive to schizophrenics, but appeared to be related to chronic treatment with neuroleptic drugs. Symptom severity was generally similar in schizophrenic abusers and non-abusers, which also suggested a degree of independence from the disease process. In a majority of the studies surveyed, abuse of stimulants followed disease onset. It was also found that stimulant abuse was associated with marked increases in hospitalization in this patient group, including those known to be neuroleptic medication compliant. Possible explanations for the initiation and maintenance of psychostimulant abuse in schizophrenics are discussed in relation to clinical and preclinical evidence on drug addiction.
作者从1975年至1994年间发表的文章中挑选出那些依据近期相对统一的诊断标准明确记录了被判定为精神分裂症患者存在精神兴奋剂滥用情况的文章。这些文章表明，精神分裂症患者中精神兴奋剂滥用的发生率比普通人群高2至5倍。此外，与普通人群中老年人兴奋剂使用量下降的情况不同，精神分裂症患者中滥用率似乎维持在较高水平。尽管该群体中的滥用发生率较高，但通过自我报告得出的滥用率与尿液分析得出的滥用率相比较，结果显示滥用频率被低估了15%至21%。研究人员评估了导致精神分裂症患者滥用兴奋剂的潜在因素，包括疾病进程以及慢性抗精神病药物的影响。结果表明，精神兴奋剂滥用的发生率既不是精神科患者的普遍特征，也并非精神分裂症患者所独有，而是似乎与抗精神病药物的长期治疗有关。精神分裂症滥用者和非滥用者的症状严重程度通常相似，这也表明滥用在一定程度上与疾病进程无关。在大多数被调查的研究中，兴奋剂滥用发生在疾病发作之后。研究还发现，兴奋剂滥用与该患者群体住院率的显著增加有关，包括那些已知依从抗精神病药物治疗的患者。文章结合药物成瘾的临床和临床前证据，讨论了精神分裂症患者开始并持续滥用精神兴奋剂的可能原因。
