The impact of substance use disorders on the course of schizophrenia—A 15-year follow-up study
Abstract
Background This follow-up study compared patients with schizophrenia with co-occurring substance use disorder to patients with schizophrenia and no substance use disorder.Aims To investigate the prognostic significance of the effects of substance use disorders on the course of schizophrenia.Method Patients with schizophrenia and co-occurring substance use disorder (n=107), and patients with schizophrenia only (n=119) were followed over a 15-year period through the use of national hospitalization registers, data for time and cause of death, and data for homelessness or institutionalization.Results The median length of psychiatric hospitalization was 12 days for a patient with dual diagnosis, and 21 days for patients with schizophrenia only. Patients with dual diagnosis displayed a significantly elevated usage of all types of hospital contacts except inpatient treatment for non-psychiatric disorders. In three types of hospital contacts, patients with co-occurring substance use had approximately two to three times as many hospitalizations as did patients with schizophrenia only. Rates for homelessness and institutionalization were similar in both groups. Patients with a dual diagnosis were also significantly more at risk of dying during follow-up than were patients with schizophrenia only.Conclusions The findings suggest that the long-term course of schizophrenia is considerably more severe in patients who have a dual diagnosis compared to patients with schizophrenia only Substance use disorders have a substantial impact on the hospitalization rates of patients with schizophrenia, as well as on life expectancy. Patients with co-morbid substance abuse are more likely to be admitted for treatment during a given year although they have briefer contact with treatment.
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A study focusing on patients with schizophrenia and substance abuse found age at death particularly low (49 years).
“A study focusing on patients with schizophrenia and substance abuse, i.e., a dual diagnosis (Schmidt et al. 2011), found that age at death for these patients was particularly low (49 years).”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Schmidt et al. 2011
Conflicting results have been recently reported as to whether illicit drug use contributes to excess mortality in psychosis.
“Conflicting results have been recently reported as to whether illicit drug use contributes to excess mortality in psychosis.2,25,26”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [26]
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Outcome of patients with dual diagnosis in secondary psychiatric care
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- Authors
- Schmidt, L. M., Hesse, M., & Lykke, J.
- Affiliations
- Sankt Hans Hospital (DK)
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 130
- Issue
- 1-3
- Pages
- 228-233
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2022066531
- Cited by
- 171
- References
- 16
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 10 · 2023: 8 · 2022: 12 · 2021: 10 · 2020: 13 · 2019: 13 · 2018: 15 · 2017: 15 · 2016: 12 · 2015: 11 · 2014: 10 · 2013: 17 · 2012: 10
- FWCI
- 8.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- schizophrenia, substance use disorders
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cause of Death, Cross-Sectional Studies, Denmark, Female, Ill-Housed Persons, Humans, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Prognosis, Psychiatric Department, Hospital, Risk Factors, Schizophrenia, Time Factors, Diagnosis, Dual (Psychiatry), Substance-Related Disorders, Young Adult
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