Quality of life among dually diagnosed and non-substance-using male schizophrenia outpatients

35 SAJP June 2013 Vol. 19 No. 2 Clinical and epidemiological studies have reported up to 47% substance-use disorder (SUD) comorbidity in patients with schizophrenia. [1] Addressing SUD comorbidity is clinically relevant since it has a significant impact on the course and prognosis of schizophrenia. For example, it can lead to acute bouts of hospitalisation by reducing patient compliance with antipsychotic treatment.[2] Among psychiatric patients, particularly ones with schizophrenia, comorbidity has been associated with more frequent emergency room visits, criminality, violence, increased fluctuation and severity of psychiatric symptoms, legal problems and family stress.[3-5] Aside from the pharmacological treatments used for reducing symptoms, researchers have started to place greater importance on patient satisfaction, treatment assessment by the patient, and patients’ subjective well-being in the last few years. Thus, researchers’ emphasis on evaluating and enhancing quality of life (QoL) in patients with schizophrenia is gradually increasing.[6-8] The World Health Organization Quality of Life Scale Brief Version scale (WHOQOLBREF) assesses individuals’ self-perception of their position in life within the context of the culture and value systems in which they live, and in relation to their goals, expectations and concerns.[9-11] Few studies describing the QoL of schizophrenia patients have been published to date, and even fewer have compared the QoL of schizophrenia patients with and without SUD comorbidity. Two studies examining the effects of SUD on schizophrenia outpatients identified significantly lower QoL scores in the comorbid group,[12,13] but the paucity of such studies indicates that this question is still under-explored and merits further investigation. Furthermore, there is very little information in Turkey regarding the QoL of the patients with both schizophrenia and SUD. In this study, we aimed to assess the QoL of patients dually diagnosed with schizophrenia and SUD, and in non-substance-using male schizophrenia outpatients. It was assumed that due to the neurotoxic, physical and medical effects engendered by substance use, the comorbid group would report poorer QoL scores than schizophrenia patients with no SUD.