What is the relationship between schizophrenia and addictions?

Although psychiatric illnesses and psychological disorders are defined and limited in diagnostic manuals, beyond the pages the reality is that in practice there are many pathologies that overlap in various aspects.

So, for example, some symptoms may be typical of depression and bipolar disorder, and only insight into a patient’s mental processes and behavior can distinguish which disorder is affecting them.

But these blurred boundaries between pathologies are present even at the dividing lines between disorders that look like virtually nothing. This is for example what happens when we observe that a large part of people who develop one disease also develop the other… which is the case with schizophrenia and addictive disorders.

In this article, we will explore the topic of what is the relationship between schizophrenia and drug addiction, and what implications this has for the treatment of these pathologies.

    What is schizophrenia?

    Schizophrenia is a mental illness that affects approximately 0.5% of the general population at some point in their lives, being the most common psychotic disorder.. Although it may first express itself in childhood or adolescence, it is most common for its symptoms to start showing up between the ages of 25 and 30.

    Because it is a pathology linked to the spectrum of psychotic disorders, schizophrenia is associated with the concept of breaking with reality; that is, those who develop it undergo serious alterations in the basic processes for having personal autonomy, such as the perception and interpretation of facts, and the management of thoughts and emotions. These symptoms are not always present, but are expressed throughout the “crisis”, although in some cases the beginning and the end of these episodes can be gradual and not very marked.

    In addition to being varied, Symptoms of schizophrenia can be divided into two types: positive symptoms and negative symptoms.. The first includes all the alterations characterized by the presence of strange elements in the way of thinking or perceiving things of the person: hallucinations and delusions, mainly. For their part, negative symptoms are characterized by the lack of elaboration or intention in the psychological processes necessary to live properly in society and have a good quality of life, such as the lack of emotional response to important events, poverty. of “the use of language, or the persistent tendency to social isolation.”

    This set of symptoms has internal and external causes, and many can be facilitated by the social dynamics that occur around the person (the clearest example is social isolation).

    In all cases, another hallmark of schizophrenia is its unsettling nature of people’s lives, which is associated with a greater predisposition to develop other psychiatric illnesses or psychological disorders.

      What is the link between addictions and schizophrenia?

      As we move forward, there is a lot of evidence that people with one or more addictions (with multiple drug addiction) are overrepresented among those who have developed schizophrenia. which means among people diagnosed with schizophrenia, the proportion of people with addiction to psychoactive substances is much higher than the average population Generally. Thus, while between 16% and 20% of the population has developed a drug addiction disorder (legal or illegal), in which they have been diagnosed with schizophrenia, this percentage rises to 47%. The drugs most consumed by this segment of the population after tobacco are alcohol, cannabis and cocaine.

      The implications of this phenomenon are serious, because while addictive disorders are in themselves pathologies that must be treated as soon as possible, drug addiction and dependence make people with schizophrenia statistically more prone to psychotic attacks, rather than – compliance with doctor’s instructions or with discontinuation of treatment. , adopting violent behavior, losing autonomy and developing suicidal thoughts, among others. In addition, this group of patients are more likely to relapse into drug use after trying to overcome addiction.

      Like that, drug use worsens the development of schizophrenia, but it also creates the right conditions for the person to develop other psychological disorders. (like depressive disorders) which result from the accumulation of behavioral and emotional disorders and disorders generated by this combination of pathologies.

        What are the causes of this relationship between diseases?

        The causes of this relationship between schizophrenia and drug addiction are not yet well understood; that is, the causal mechanisms behind this overlap remain relatively hidden. In any event, the scientific consensus is that there is not a single cause, but a combination of several biosocial factors that interact with each other.

        However, in recent years, several hypotheses have been suggested based on increasingly empirical evidence. One is the self-medication hypothesis in people with schizophrenia, whereby those who develop this disease try to incorporate elements into their nervous systems that help them restore some balance in the chemical imbalance generated by the disease. schizophrenia. Like that, drug use would be a semi-unconscious way to “counter” neuropsychological disorders from which arise the symptoms of the pathology.

        On the other hand, the hypothesis of a genetic predisposition should also be emphasized. According to this, there are a number of genetic patterns that underlie both the propensity to develop schizophrenia and the propensity to “stick” to a drug. In any case, the idea that the two pathologies fall without more or less of the genetic code is denied; simply, a combination of certain alleles would contribute to the appearance of these health problems, but it would not be a determining factor.

        Also, we know that the consumption of certain drugs can trigger a psychotic picture which consolidates into schizophrenia, so that once an addiction has set in, it is easier to show a predisposition to schizophrenia.

          Are you looking for treatment for addictive disorders?

          If you are looking for a treatment for addictions with or without substances, contact our team of professionals.

          A CITA clinics we specialize in the intervention of this class of pathologies, and we offer both outpatient care and complete detoxification, detoxification and rehabilitation treatments by entering our residential module located in Dosrius (Barcelona). In our fully equipped facilities, we work in both medicine and psychotherapy to help patients break the vicious cycle of addiction and gain health and quality of life while minimizing the risk of relapses.

          Bibliographical references

          • American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
          • Batel, P. (2000). Dependence and schizophrenia. European Psychiatry, 15 (2): p. 115 – 122.
          • Dunn, N .; Cook, CC (1999). Psychiatric aspects of alcohol abuse. Hospital medicine. 60 (3): p. 169 – 172.
          • Ferri, FF (2010). Ferri’s Differential Diagnosis: A Practical Guide to the Differential Diagnosis of Clinical Symptoms, Signs, and Disorders. Philadelphia, PA: Elsevier / Mosby.
          • Kauer, investigating judge; Malenka RC (2007). Synaptic plasticity and addiction. Nature Reviews Neuroscience, 8: p. 844 – 858.
          • Khokhar, JI et al. (2019). The link between schizophrenia and substance use disorders: a unifying hypothesis. Schizophrenia Research, 194: pp. 78 – 85.
          • Potvin, S .; Stip, E .; Schizophrenia and addiction: an assessment of the self-medication hypothesis. The Brain, 29 (3 Pt 1): pp. 193 – 203.
          • Saha, S .; Singing, D .; McGrath, J. (2007). A systematic review of mortality in schizophrenia: is the differential mortality gap widening over time ?. General Psychiatry Archives, 64 (10): p. 1123 – 1131.

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