Working memory and depressive symptoms in patients with schizophrenia and substance use disorders

Fernand-Seguin Research Center, University of Montreal, Montreal, Canada.
Cognitive Neuropsychiatry (Impact Factor: 1.91). 08/2008; 13(4):357-66. DOI: 10.1080/13546800802264330
Source: PubMed


Substance abuse is highly prevalent in schizophrenia and it has been associated with negative consequences on the course of the pathology. Regarding cognition, the prevailing literature has produced mixed results. Some groups have reported greater cognitive impairments in dual diagnosis schizophrenia, while other groups have described the reverse.
The current cross-sectional study sought to investigate the potential differences in psychiatric symptoms and cognition between schizophrenia patients with and without substance use disorders.
Fifty-three schizophrenia patients were divided into two groups: with (n=30) and without (n=23) a substance use disorder (DSM-IV criteria). Psychiatric symptoms were measured with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). Psychomotor speed and spatial working memory were measured using Cambridge Neuropsychological Tests Automated Battery (CANTAB).
Patients in the dual diagnosis group displayed more severe depressive symptoms and poorer strategy during the working memory task.
These results are in keeping with the prevailing literature describing negative consequences of substance abuse in schizophrenia. Substance abuse may exacerbate depressive symptoms and interfere with metacognition in schizophrenia.

Download full-text


Available from: Emmanuel Stip, Aug 06, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Not Available
    No preview · Conference Paper · Nov 1988
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To determine whether first episode psychosis (FEP) patients who meet criteria for substance abuse have worse outcomes than FEP patients who do not abuse substances. Method: A systematic literature search was conducted using MEDLINE, PSYCHInfo, Cochrane controlled trial register, and other databases to find prospective studies comparing outcomes for FEP patients with and without substance abuse. Both schizophrenia spectrum and affective spectrum patients were included in the review. Outcomes included positive and negative symptoms, risk of relapse, re-hospitalization, treatment compliance and psychosocial variables. Results: Twelve studies met inclusion criteria. Compared to FEP patients without substance abuse, patients with substance abuse experienced increased positive symptoms in five out of seven studies; increased risk of relapse in two out of two studies; and increased risk of poor treatment compliance in three out of five studies. Only one of six studies examining negative symptoms found a significant association with substance abuse and only one out of eight studies found any associations between psychosocial outcomes and substance abuse. Conclusions: FEP patients with co-morbid substance abuse may experience increased risk of relapse, increased positive symptoms and poor compliance, but negative symptoms and psychosocial variables may not be affected.
    No preview · Article · Jul 2009 · Current Psychiatry Reviews
  • [Show abstract] [Hide abstract]
    ABSTRACT: While research on the management of co-occurring addictive and mental disorders (AMDs) has grown substantially in recent years, we still have little guidance on specific strategies. Consideration of epidemiological research and ethical principles can supplement existing clinical trials in providing a way forward. High frequencies of co-occurring disorders, equity of access for affected individuals and potential clashes between services in priorities and procedures, suggest that a stepped model of care by a single service may often be required. Typically, problems are multiple rather than dual, with potential for mutual influence, suggesting a need for interventions that are sensitive to and encompass complex co-occurring problems. Motivational problems are endemic, initial gains are often partial and unstable, and relapses potentially have serious consequences, suggesting a need for long-term, assertive follow-up. Principles such as these provide a solid framework for designing both services and interventions. However, there is a continuing need for controlled trials that unpack effective components of interventions, and increase their impact.
    No preview · Article · Oct 2009 · Addictive behaviors
Show more