Substance use and schizophrenia: adverse correlates in the CATIE study sample
Abstract
Objective This study examined the relationship between severity of illicit substance use at the time of study entry in a sample of patients diagnosed with schizophrenia and 18-month longitudinal outcomes, including psychopathology, depression, neurocognition, and quality of life.Methods Subjects in the Clinical Antipsychotic Trials of Intervention Effectiveness (N=1432) were divided into three groups according to baseline data: (1) those with moderate/severe drug use, (2) those with mild drug use, and (3) non-users of illicit substances. The groups were compared on other baseline characteristics. Mixed model analysis was used to compare outcomes between the groups using all available outcome data over 18 months, controlling for potential confounding baseline characteristics. Least square means were compared between pairs of groups in the mixed models.Results Significantly poorer outcomes were observed in the domains of psychosis, symptoms of depression, and quality of life for moderate/severe drug users in comparison with both mild users and abstainers. No significant differences were found on neurocognitive functioning or days of employment.Conclusions This study suggests that drug use-related impairment co-morbid with schizophrenia may not be a function of use per se but rather, of the severity of use. It highlights the importance of comprehensive assessment and treatment of illicit substance abuse in schizophrenia. Long-term treatment approaches that integrate harm reduction strategies may offer promise in maximizing positive outcomes for such dually diagnosed patients.
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Substance use in concomitant disorders is associated with more severe symptomatology than noncomorbid severe mental illness.
“Substance use in concomitant disorders is associated with more severe symptomatology than noncomorbid SMI (25).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [25]
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Kouakou, M. R., Cabrera‐Mendoza, B., Pathak, G. A., Cannon, T. D., & Polimanti, R. A. (2023) · medRxiv · doi:10.1101/2023.09.25.23296085
(2016) · Wiley eBooks · doi:10.1002/9781394259472.refs
Kouakou, M. R., Cabrera‐Mendoza, B., Pathak, G. A., Cannon, T. D., & Polimanti, R. A. (2024) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae093
Linking Substance Use and Schizophrenia
Mutlu, E., Özden, H. C., & Ertuğrul, A. (2025) · Springer eBooks · doi:10.1007/978-3-031-73363-5_179
- Authors
- Kerfoot, K. E., Rosenheck, R. A., Petrakis, I. L., Swartz, M. S., Keefe, R. S. E., McEvoy, J. P., & Stroup, T. S.
- Affiliations
- Yale University (US)
- Duke University (US)
- Columbia University (US)
- Corresponding author
- Kerfoot, Karin E.
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 132
- Issue
- 2-3
- Pages
- 177-182
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W1999646972
- Cited by
- 70
- References
- 41
- Citations by year
- 2025: 3 · 2024: 6 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 5 · 2016: 5 · 2015: 6 · 2014: 4 · 2013: 10 · 2012: 7
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Office of Academic Affiliations, Department of Veterans Affairs
- National Institute of Mental Health (NO1 MH90001)
- 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, illicit drug use
- MeSH terms
- Adolescent, Adult, Aged, Clinical Trials as Topic, Female, Humans, Longitudinal Studies, Male, Middle Aged, Schizophrenia, Severity of Illness Index, Statistics as Topic, Antipsychotic Agents, Comorbidity, Treatment Outcome, Substance-Related Disorders, Young Adult
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