SELF-REPORTS OF THE INTERACTION BETWEEN SUBSTANCE-ABUSE AND SCHIZOPHRENIA

Fifty-three psychiatric hospital inpatients with a dual diagnosis of s ubstance abuse and schizophrenia were given the Brief Symptom Inventor y and the Schizophrenia/Substance Abuse Interview Schedule. Mean age w as 29; 49 were men. Only 11% were employed. Forty percent abused mainl y alcohol, 40% cannabis and 8% amphetamines; 20% abused more than one substance. Mean onset age of drug abuse was 16 years; schizophrenia wa s diagnosed a mean of 5 years later, and subjects had been admitted to hospital an average of 7 times since then. Most believed that drug ab use initiated or exacerbated their schizophrenia; 80% took drugs prima rily to relieve dysphoria and anxiety. Amphetamines improved subjectiv e well-being significantly more than alcohol, but choice of drugs was determined mainly by price and availability. Only cannabis increased p ositive symptoms of schizophrenia and only amphetamines reduced negati ve ones. Effectively treating this population requires an integration of psychiatric and drug treatment services, ideally in a community con text.