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Substance misuse among people with schizophrenia: similarities and differences between the UK and France

Published online by Cambridge University Press:  02 January 2018

A. Dervaux
Affiliation:
Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Prs H, Lôo et J,-P, Olié, Centre Hospitalier Sainte-Anne, 1 Rue Cabanis, F-75014, Paris, France
F. J. Bayle
Affiliation:
Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Prs H, Lôo et J,-P, Olié, Centre Hospitalier Sainte-Anne, 1 Rue Cabanis, F-75014, Paris, France
M.-O. Krebs
Affiliation:
Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Prs H, Lôo et J,-P, Olié, Centre Hospitalier Sainte-Anne, 1 Rue Cabanis, F-75014, Paris, France
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Abstract

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Columns
Copyright
Copyright © Royal College of Psychiatrists, 2002 

We read with interest the paper by Duke et al (Reference Duke, Pantelis and McPhillips2001) reporting on non-alcohol substance misuse among people with schizophrenia. We recently conducted a study addressing that question among patients with schizophrenia from the Parisian suburbs, using the Composite International Diagnostic Interview for DSM—III—R diagnoses of substance abuse or dependence (Reference Dervaux, Bayle and LaqueilleDervaux et al, 2001). We found that 41% of the patients had a lifetime history of substance abuse or dependence, including 30% on a drug other than alcohol (v. 16% in the Duke et al study). As in Duke et al's study, in our study the patients with substance abuse were younger than nonabusers. We also found no difference in respect of psychiatric symptoms using the Positive and Negative Syndrome Scale, mean age of first psychiatric treatment or mean number of previous hospitalisations. The patterns of consumption were slightly different for cannabis (27% of the patients in Paris v. 18.7% in London) and opiates (7% v. 5.3%, respectively). The main difference concerned the misuse of cocaine and crack, less common in France (1%) than in the UK (8.7%), and considerably less than in North American studies (ranging from 20 to 30%; Reference Cantor-Graae, Nordstrom and McNeilCantor-Graae et al, 2001). Although methodological issues could explain some of these differences (e.g. the use of different assessment instruments; mean age of the subjects was 34.7 years in our study v. 50.3 years in the English study), these patterns most probably reflect the different availability of drugs in these countries. Taken together, these observations do not argue in favour of the self-medication hypothesis but instead emphasise the role of alternative, and probably multiple, factors leading to substance misuse in schizophrenia.

Footnotes

EDITED BY MATTHEW HOTOPF

References

Cantor-Graae, E., Nordstrom, L. G. & McNeil, T. E. (2001) Substance abuse in schizophrenia: a review of the literature and a study of correlates in Sweden. Schizophrenia Research, 48, 6982.Google Scholar
Dervaux, A., Bayle, F.-J., Laqueille, X., et al (2001) Is substance abuse in schizophrenia related to impulsivity, sensation seeking or anhedonia? American Journal of Psychiatry, 158, 492494.Google Scholar
Duke, P. J., Pantelis, C., McPhillips, M. A., et al (2001) Comorbid non-alcohol substance misuse among people with schizophrenia. Epidemiological study in central London. British Journal of Psychiatry, 179, 509513.Google Scholar
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