Clinical presentations and therapy of polysubstance dependence in patients with schizophrenia

Abstract

The article presents the results of a clinical therapeutic and follow-up study of patients with a 'dual diagnosis' (polysubstance dependence comorbid with schizophrenia: paranoid schizophrenia or schizotypal disorder). To study clinical/dynamic changes of polysubstance dependence in patients with schizophrenia (paranoid schizophrenia, schizotypal disorder) and to evaluate the duration and quality of therapeutic remissions. Two hundred and sixty-six male patients, including 176 patients with dependence syndrome and 90 patients with both dependence syndrome and schizophrenia, were studied. Patients with the 'dual diagnosis' are characterized by early social maladjustment, earlier social deformation, lack of social skills and preference for a lonely lifestyle. The clinical and dynamic characteristics of dependence syndrome in patients with 'dual diagnosis' include older age of the first use of a psychoactive substance (PS), preference of alcohol as the first PS, experiment as the most frequent motivation for using PS (due to thought disorder), and the treatment of psychopathological disorders (PS like medicine) with a chaotic pattern being the most common in the use, a tendency to hospitalism. The success of the treatment of patients with 'dual diagnosis' is possible by combining the therapy of endogenous disease and polysubstance dependence.