Substance use and psychosis

BACKGROUND:The use of alcohol and illicit substances is high among people with mental illnesses. Clinicians experience a range of complex issues while treating such patients. OBJECTIVE: This article provides a brief overview of the problem of substance abuse comorbidity in people with a major mental illness. It outlines some of the epidemiological and clinical issues related to the association between the use of alcohol and illicit substances and disorders such as schizophrenia, and suggests approaches to assessment and treatment of people with such dual problems. DISCUSSION: An integrated approach to treatment is required, whereby mental health and substance use issues are addressed simultaneously by the one treatment team. The general practitioner has an important role in psychoeducation, physical and mental health care, pharmacotherapy, and coordination of care. (author abstract)