ALCOHOL, CANNABIS, NICOTINE, AND CAFFEINE USE AND SYMPTOM DISTRESS INSCHIZOPHRENIA

The high prevalence of substance use, e.g., alcohol and illegal and no nprescribed drugs, in schizophrenia is widely recognized. One explanat ion for this high prevalence is that substance use may be a self-initi ated method for managing symptoms. To test whether the intake of four substances-alcohol, cannabis, nicotine, and caffeine-would increase wi th increases in symptom distress, daily self-reports of symptom distre ss and substance intake over 12 weeks were analyzed with pooled time s eries analyses. Compliance with neuroleptic medication was added to th e analyses to control for any changes in prescribed medication complia nce while using nonprescribed drugs or alcohol. Of the four substances studied, only nicotine was significantly related to symptom distress. Higher distress with prodromal symptoms was related to decreases in n icotine use. Analysis of caffeine did not meet the criteria for signif icance but does provide direction for further research. Higher distres s, with neurotic symptoms, was related to increases in caffeine use. F urther research is needed to clarify the relationship between nicotine and symptoms.