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Abstract
BackgroundAlcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. Most previous studies on the effect of alcohol use in patients with schizophrenia had limitations of small sample size or a cross-sectional design. Therefore, we used a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia.MethodsData from the Health Insurance Review Agency database in South Korea from January 1, 2007 to December 31, 2016 were used. Among 64,442 patients with first-episode schizophrenia, 1598 patients with comorbid AUD were selected based on the diagnostic code F10. We performed between- and within-group analyses to compare the rates of psychiatric admissions and emergency room (ER) visits, and medication possession ratio (MPR) between the patients with comorbid AUD and control patients matched for the onset age, sex, and observation period.ResultsThe rates of psychiatric admissions and ER visits in both groups decreased after the time point of diagnosis of AUD; however, the decrease was significantly greater in the patients with comorbid AUD compared to the control patients. While the comorbid AUD group showed an increase in MPR after the diagnosis of AUD, MPR decreased in the control group. The rates of psychiatric admissions, ER visits, and MPR were worse in the comorbid AUD group both before and after the diagnosis of AUD.ConclusionsThe results emphasize an importance of psychiatric comorbidities, especially AUD, in first-episode schizophrenia and the necessity of further research for confirmative findings of the association of AUD with clinical outcomes of schizophrenia.
Highlights
Alcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia
Demographic and clinical characteristics of the study population Of a total of 64,442 patients with incident first-episode schizophrenia, 1598 (2.48%) patients were included in the comorbid AUD group
Of the 62,844 schizophrenia patients without AUD, 1598 patients were selected as the controls which were matched for the onset age, sex, and observation period (Table 1)
Summary
Alcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia. The neonatal ventral hippocampal lesion (NVHL) model, which was led by the neurodevelopmental theory of schizophrenia, has been introduced to explain the high prevalence of AUD among patients with schizophrenia [2]. In this animal model of schizophrenia, rats who received small, bilateral hippocampal lesions at the end of the first week of life manifest schizophrenia-like social deficits in adulthood [5]. Alcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. We used a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia
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