Substance use disorder comorbidity with schizophrenia in families of Mexican and Central American Ancestry

Abstract 

Objectives

The aims of this study were to estimate the frequency and course of substances use disorders in Latino patients with schizophrenia and to ascertain risk factors associated with substance use disorders in this population.

Method

We studied 518 subjects with schizophrenia recruited for a genetic study from the Southwest United States, Mexico, and Central America (Costa Rica and Guatemala). Subjects were assessed using structured interviews and a best estimate consensus process. Logistic regression, χ², t test, Fisher's exact test, and Yates' correction, as appropriate, were performed to assess the sociodemographic variables associated with dual diagnosis. We defined substance use disorder as either alcohol or substance abuse or dependence.

Results

Out of 518 patients with schizophrenia, 121 (23.4%) had substance use disorders. Comorbid substance use disorders were associated with male gender, residence in the United States, immigration of Mexican men to the United States, history of depressive syndrome or episode, and being unemployed. The most frequent substance use disorder was alcohol abuse/dependence, followed by marijuana abuse/dependence, and solvent abuse/dependence.

Conclusion

This study provides data suggesting that depressive episode or syndrome, unemployment, male gender, and immigration of Mexican men to the United States were factors associated with substance use disorder comorbidity in schizophrenia. Binary logistic regression showed that country of residence was associated with substance use disorder in schizophrenic patients. The percentage of subjects with comorbid substance use disorders was higher in the Latinos living in the United States compared with subjects living in Central America and Mexico.

Abbreviations: DD, dual diagnosis, SC, schizophrenia, SUDs, substance use disorders, US, United States, NIMH, National Institute of Mental Health, DIGS, Diagnostic Interview for Genetics Studies, FIGS, Family Interview for Genetics Studies, DSM-IV, The Diagnostic and Statistical Manual of Mental Disorders 4th Edition, PCP, phenylcyclohexylpiperidine, LSD, lysergic acid diethylamide

Keywords: Alcohol, Drug abuse, Substance misuse, Dual diagnosis, Schizophrenia, Latino populations