The prevalence of comorbid substance misuse and its influence on suicidal ideation among in-patients with schizophrenia

Objective: To estimate the prevalence, and identify the clinical correlates of comorbid substance misuse (abuse or dependence) among readmissions with schizophrenia, particularly to establish whether comorbid substance misuse is associated with higher rates of depressive symptoms and suicidal ideati on. Method: Over 12 months, consecutive readmissions from a catchment area psyc hiatric service with DSM-IV schizophrenia/schizoaffective disorder were ass essed using clinical assessments of symptomatology including depression, in sight and compliance. Comorbid substance misuse was diagnosed using DSM-IV criteria. Results: Of 102 readmissions 40% had lifetime, while 20% had current comorb id substance misuse and were predominately young males. Comorbid substance misuse had no statistically significant impact on positive, negative or dep ressive symptomatology. However, those currently misusing substances report ed more suicidal ideation compared with past or non-substance misusers. Conclusion: Readmissions with comorbid substance misuse were more likely to report suicidal ideation, and may represent a group of individuals who are at higher risk of suicide.