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Vol 18, No 3 (2021)
Research paper
Published online: 2021-07-13
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Schizophrenia and substance use disorder: a retrospective study of a dual diagnosis patients cohort

Fabiana Ventura1, Mariana Jesus1, César Mendes1, Carla Silva1
Psychiatria 2021;18(3):182-189.


Introduction: Approximately 47% of patients with Schizophrenia have criteria for a dual diagnosis. The consumption
of illicit substances, particularly cannabis, is quite prevalent in these patients, being associated with an
increase in mortality and morbidity and worse social outcomes. This study aims to understand the relationship
between Schizophrenia and substance use disorders (SUD).

Material and methods: A retrospective study was designed, including patients diagnosed with schizophrenia
admitted to the Psychiatric Ward between January 2017 and June 2019.

Results: 205 patients were included, 49 women (23.9%) and 156 men (76.1%). Of these, 29.1% consumed
psychoactive substances at the first hospitalization, mainly cannabis (24.1%), with higher prevalence in men.
The average age at the first admission was significantly lower for substance users than for non-users. The presence
of consumption in the first hospitalization, the number of hospitalizations and treatment adherence were associated
with the maintenance of consumption after the first hospitalization. The presence of consumption at the
first hospitalization is a significant predictor of its maintenance. Patients who do not adhere to treatment were
more likely to maintain consumption. The number of future hospitalizations was associated with early age at the
first hospitalization, non-compliance to treatment and maintenance of consumption after the first hospitalization.

Conclusions: We verify that the consumption of psychoactive substances is associated with the early age at the
first hospitalization, whit the reduced compliance to treatment and the increased number of hospitalizations.
Comorbid substance use disorders should be treated as early as possible to minimize the long-term effects of
substance use on patients with schizophrenia in Dual Diagnosis programs.

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