Severe Psychotic Disorders and Substance Use Patterns

Sarah M. Hartz, MD, PhD Assistant Professor of Psychiatry Washington University in St. Louis, MissouriMedicalResearch.com Interview with:
Sarah M. Hartz, MD, PhD
Assistant Professor of Psychiatry
Washington University in St. Louis, Missouri

MedicalResearch.com: What are the main findings of this study?

Dr. Hartz: This is the first large-scale study to comprehensively evaluate substance use in people with schizophrenia, bipolar disorder, and other severe mental illness.We found that people with severe mental illness have rates of smoking, alcohol use, and other substance use that are 3 to 5 times higher than people in the general population.
MedicalResearch.com: Where any of the findings surprising?

Dr. Hartz: What I found most striking is that certain patterns of substance use do not apply to people with severe mental illness. Although in the general population women have lower substance use rates than men, and Asian Americans have lower substance use rates than Caucasian Americans, we do not see these differences among people with severe mental illness: in individuals with severe mental illness, substance use among men and women is the same, and substance use among Asian Americans and Caucasian Americans is the same.

Also, although our nation-wide anti-tobacco campaigns have successfully reduced smoking rates of young adults in the general population, among people with severe mental illness, the smoking rates of young adults are as high as smoking rates in middle-aged adults. This suggests that people with severe mental illness are using substances for very different reasons than other people whose substance use seems more affected by cultural forces.

MedicalResearch.com: What should patients and providers take away from this report?

Dr. Hartz: The clinical ramifications are that substance use and severe mental illness go hand-in-hand. We need to treat smoking, alcohol and other substance use disorders in addition to the other severe mental illness.

Citation:

Comorbidity of Severe Psychotic Disorders With Measures of Substance Use

Hartz SM, Pato CN, Medeiros H, et al. Comorbidity of Severe Psychotic Disorders With Measures of Substance Use. JAMA Psychiatry. 2014;():. doi:10.1001/jamapsychiatry.2013.3726