Hambrecht M, Häfner H
Central Institute of Mental Health, Mannheim, Germany.
Biol Psychiatry. 1996 Dec 1;40(11):1155-63. doi: 10.1016/S0006-3223(95)00609-5.
Up to 60% of chronic schizophrenic patients are reported to abuse alcohol or drugs. This comorbidity raises the question whether one disorder is a consequence of the other. With the structured interview "IRAOS," the onset and course of schizophrenia and substance abuse were retrospectively assessed in a representative first-episode sample of 232 schizophrenic patients. Information by relatives validated the patients' reports. Alcohol abuse prior to first admission was found in 24%, drug abuse in 14%-twice the rates in the general population. Alcohol abuse more often followed than preceded the first symptom of schizophrenia. Drug abuse preceded the first symptom in 27.5%, followed it in 37.9%, and emerged within the same month in 34.6% of the cases. The study demonstrates a remarkable association between first-episode schizophrenia and substance abuse, but a unidirectional causality is not supported, nor is a specific psychotic disorder in comorbid cases.
据报道，高达60%的慢性精神分裂症患者存在酒精或药物滥用问题。这种共病现象引发了一个问题，即一种疾病是否是另一种疾病的结果。通过结构化访谈“IRAOS”，对232例精神分裂症患者的代表性首发样本进行了回顾性评估，以了解精神分裂症和物质滥用的发病情况及病程。亲属提供的信息对患者的报告进行了验证。首次入院前存在酒精滥用的患者占24%，药物滥用的患者占14%，这一比例是普通人群的两倍。酒精滥用更多地发生在精神分裂症首发症状之后而非之前。药物滥用在27.5%的病例中先于首发症状出现，在37.9%的病例中在首发症状之后出现，在34.6%的病例中在同一月内出现。该研究表明首发精神分裂症与物质滥用之间存在显著关联，但不支持单向因果关系，也不支持共病病例中存在特定的精神障碍。
