Stimulant and other substance use disorders in schizophrenia: prevalence, correlates and impacts in a population sample

Sara, Grant E., Burgess, Philip M., Malhi, Gin S., Whiteford, Harvey A. and Hall, Wayne C. (2014) Stimulant and other substance use disorders in schizophrenia: prevalence, correlates and impacts in a population sample. Australian and New Zealand Journal of Psychiatry, 48 11: 1036-1047. doi:10.1177/0004867414533838

Author Sara, Grant E.
Burgess, Philip M.
Malhi, Gin S.
Whiteford, Harvey A.
Hall, Wayne C.
Title Stimulant and other substance use disorders in schizophrenia: prevalence, correlates and impacts in a population sample
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 1440-1614
Publication date 2014-11-11
Year available 2014
Sub-type Article (original research)
DOI 10.1177/0004867414533838
Open Access Status
Volume 48
Issue 11
Start page 1036
End page 1047
Total pages 12
Place of publication London, United Kingdom
Publisher Sage Publications
Collection year 2015
Language eng
Formatted abstract
Objectives: Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimulant abuse in people with schizophrenia. This study examined the prevalence and correlates of stimulant and other drug disorders in a population-based sample of people with schizophrenia, examining associations with frequent service use, physical health comorbidities and accommodation instability.

Methods: New South Wales (NSW) hospital, community mental health and emergency department data were used to examine health service contact over 5 years in 13,624 people with a diagnosis of schizophrenia. Associations of stimulant disorders were examined with multinomial logistic regression, comparing people with no substance disorders to those with cannabis disorders, stimulant disorders or both.

Results: Of people with schizophrenia, 51% had substance disorders, including 14% with stimulant disorders. Stimulant disorders were more common in young adults and in urban areas, less common in migrants, and unrelated to initial social disadvantage. More than 80% of those with stimulant disorders also had cannabis disorders. Service use and harms were most common in this group, including frequent mental health admissions (59%), frequent emergency department presentations (52%), admissions with injury or self-harm (44%), infectious disease diagnoses (22%), multiple changes of residence (61%), movement to more disadvantaged locations (42%) and periods of homelessness (18%). People with stimulant disorders alone had higher rates of self-harm, infectious disease and non-mental health admissions than people with cannabis disorders alone.

Conclusions: Stimulant disorders occur in people with schizophrenia and in first-episode psychosis at rates more than 10 times that of the broader population. Stimulant disorders are likely to worsen the burden of psychosis, and strategies are needed to engage and support the highly disadvantaged group of people with schizophrenia who have cannabis and stimulant disorders.
Keyword Amphetamine
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2015 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
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