Alcool e drogas na esquizofrenia
AUTOR(ES)
Marilia Montoya Boscolo
DATA DE PUBLICAÇÃO
2000
RESUMO
The aim of this investigation was to evaluate drug and alcohol use in schizophrenia through a comparative, case-control study of two groups of age and sex matched schizophrenics who fulfilled the DSMIV criteria for schizophrenia. The case group consisted of individuals with a previous history of alcohol use, at least, in the past month, and a history of drug use (marijuana and/ or cocaine), at least, throughout life and the past year. The control group had no such history of alcohol and drugs use. The subjects (15 patients per group), were university hospital psychiatric inpatients or were registered at CAPS (psychosocial Treatment Center) in the municipality of Campinas. The parameters studied inc1uded demographic variables, psychiatric history, psichopathology (pANSS and CGI), cognitive functioning (MMSE, verbal fluency test, EIWA, Logical Memory test), global functioning (GAS), family functioning (GARF), pharmachological treatment, extrapyramidal symptoms (ESRS, UKU), quality oflife (QLS) and subjective impression ofmedication (DAI-30 and SSAS), as well as alcohol and drugs (SSAS). The Wilcoxon-matched pairs test was used to compare continuous variables, and the Stewart-Maxwell t test and MacNemar test were used to compare categorical variables. Schizophrenic patients who used alcohol and drugs had tendency for better school achievement and less anedonia, but showed poor social adaptation, a tendency toward suicide attempts and greater use of tabacco than did schizophrenics who do not use alcohol and drugs. The patients were subjectively more alienated and reported felling like "zombies" under medication. Objectively, they had more extra pyramidal side effects and worsen negative symptoms. These patients are using antiparkinson agents medication for a shorter period of time than patients of control group are doing, This doesn t occurs neither because ofthe length oftime oftheir illness, which wasn t different for the two groups, nor because of the length of time they are using antipsychotic medication. This finding reinforces the automedication model of schizophrenic patients aliviate the uncomfortable extrapyramidal symptoms caused by antipsychotics agents, using alcohol or drugs. The subjective relation to alcohol was perceived as a social facilitator to cope with social interactions and marijuana. However, marijuana worsened the negative symptoms and accentuated thought confusion. Cocaine produced subjective happiness and more attention, although the patients felt more subjective hostility, tension and reported more varied positive and negative symptoms.
