Document Detail

Treating comorbid substance use disorders in schizophrenia.
MedLine Citation:
PMID:  20504059     Owner:  NLM     Status:  MEDLINE    
AIM: To review the literature on pharmacological and psychosocial treatment approaches for people with schizophrenia and comorbid substance use disorder(s) (SUD).
METHOD: Selective literature review.
RESULTS: Despite the high prevalence of comorbid SUD among people with schizophrenia, there is a considerable paucity of rigorously conducted randomized controlled treatment trials. While there is some evidence for clozapine, and for the adjunctive use of agents such as naltrexone for comorbid alcohol dependence, the available literature largely comprises case studies, case series, open label studies and retrospective surveys. In terms of psychosocial approaches, there is reasonable consensus that integrated approaches are most appropriate. Regarding specific aspects of care, motivational interviewing, cognitive behavioural therapy and contingency management have an emerging supportive literature, as do family interventions. However, there is no 'one size fits all', and a flexible approach with the ability to apply specific components of care to particular individuals, is required. Group-based therapies and longer-term residential services have an important role for some patients, but further research is required to delineate more clearly which patients will benefit from these strategies.
CONCLUSIONS: While there is growing (albeit limited) evidence that integrated and well articulated interventions that encompass pharmacological and psychosocial parameters can be beneficial for people with schizophrenia and comorbid SUD, there remains a considerable gap in the literature available to inform evidence-based practice.
Dan I Lubman; Joel A King; David J Castle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  International review of psychiatry (Abingdon, England)     Volume:  22     ISSN:  1369-1627     ISO Abbreviation:  Int Rev Psychiatry     Publication Date:  2010  
Date Detail:
Created Date:  2010-05-27     Completed Date:  2010-09-14     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8918131     Medline TA:  Int Rev Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  191-201     Citation Subset:  IM    
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MeSH Terms
Combined Modality Therapy
Community Mental Health Services / organization & administration
Drug Therapy / methods*
Psychotherapy / methods*
Psychotherapy, Group / methods*
Schizophrenia / epidemiology*,  therapy*
Substance-Related Disorders / epidemiology*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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