Abstract
BackgroundDespite several studies on the prevalence and pattern of substance use in Nigeria, there is little information on substance use in patients diagnosed with serious mental illness (SMI) such as schizophrenia and bipolar affective disorder (BD).AimThe aim of the study was to compare the pattern of psychoactive substance use among outpatients with BD and schizophrenia.SettingThe study was conducted in a neuropsychiatric hospital in Nigeria.MethodsSeventy five consecutive patients with a MINI-PLUS diagnosis of BD were compared with an equal number of patients obtained by systematic random sampling with a MINI-PLUS diagnosis of schizophrenia.ResultsThe respondents with schizophrenia were aged 18–59 years (37.2 ± 9.99) and were predominantly young adult (49, 65.3%), men (46, 61.3%), who were never married (38, 50.7%). Overall, lifetime drug use prevalence was 52%, while for current use, overall prevalence was 21.3%. Participants with BD were aged 18–63 years (36.7 ± 10.29) and were predominantly young adult (53, 70.7%), women (44, 58.7%), who were married (32, 42.7%), with tertiary education (31, 41.3%). Overall, lifetime drug use prevalence was 46.7%, while current overall prevalence was 17.3%. These rates (lifetime and current) for both diagnostic groups are higher than what was reported by the World Health Organization in the global status report of 2014 (0% – 16%). The statistically significant difference between the two diagnostic groups was related to their sociodemographic and clinical variables and psychoactive substance use.ConclusionPsychoactive substance use remains a burden in the care of patients diagnosed with schizophrenia and BD. Future policies should incorporate routine screening for substance use at the outpatient department with a view to stemming the tide of this menace.
Highlights
Despite worldwide concern and education about psychoactive substance use, there is limited awareness of the prevalence and pattern of psychoactive substance use among mentally ill patients.[1]
More than half of the people suffering from schizophrenia or bipolar affective disorder (BD) present with a lifetime use of psychoactive substances,[5,6,7] a rate that is much higher than that seen among individuals without bipolar and schizophrenia illnesses.[8]
If the abnormalities in the reward sub-pathway in schizophrenia and bipolar disorder are of a different nature and contribute to the risk of substance use differently in schizophrenia and BD, in addition to genetic, personality and environmental contributions, it may follow that the rates of substance abuse in schizophrenia and BD could be significantly different
Summary
Despite worldwide concern and education about psychoactive substance use, there is limited awareness of the prevalence and pattern of psychoactive substance use among mentally ill patients.[1] The United Nations reported an increasing trend worldwide in psychoactive substance use with a steady increase in the prevalence of drug abuse and its consequences in Nigeria.[2,3,4] More than half of the people suffering from schizophrenia or bipolar affective disorder (BD) present with a lifetime use of psychoactive substances,[5,6,7] a rate that is much higher than that seen among individuals without bipolar and schizophrenia illnesses.[8] This phenomenon suggests that, in addition to factors predisposing the general population to psychoactive substance use, there may be factors especially predisposing people with schizophrenia and BD to using psychoactive substances These additional factors may be related to the reward pathway shown to have abnormalities in both schizophrenia and bipolar disorder patients who are using substances.[9,10]. Despite several studies on the prevalence and pattern of substance use in Nigeria, there is little information on substance use in patients diagnosed with serious mental illness (SMI) such as schizophrenia and bipolar affective disorder (BD)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
