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Veterans with schizophrenia, alcohol abuse less likely to use care services

Recent findings indicated that veterans with schizophrenia who misused alcohol were less likely to utilize health care services than those who did not misuse alcohol; however, they reported poorer psychotic symptoms and quality of life.

“Comorbid alcohol and drug use disorders are treatable and have substantial effects on outcomes and health care utilization in people with schizophrenia. While these substance use disorders (SUDs) are thought to be common in patients with schizophrenia, it has been difficult to characterize prevalence and treatment utilization of this population, since administrative data and medical records may not identify patients with schizophrenia who have an SUD diagnosis,” Eric R. Pedersen, PhD, of RAND Corporation, Santa Monica, California, and colleagues wrote.

To assess alcohol use and service utilization among veterans receiving treatment for schizophrenia, researchers analyzed patient- and clinician-reported data for 801 individuals with schizophrenia receiving treatment within the Veterans Health Administration.

Overall, 15.3% of the cohort reported using alcohol within the past month but not to the point of intoxication, defined as alcohol users by researchers, and 7.4% reported drinking to the point of intoxication in the past month, defined as alcohol misusers.

Alcohol misusers were significantly less likely to never miss their medication, compared with participants who did not use alcohol (P < .05).

Brief Psychiatric Rating Scale (BPRS) scores were significantly worse among alcohol misusers, compared with participants who did not use alcohol (P < .05).

Alcohol misusers reported significantly worse mental health quality of life, compared with alcohol users (P < .05) and participants who did not use alcohol (P < .05).

Forty-two percent of the cohort reported using emergency services; 15% reported use of occupational assistance; and 7% reported use of housing services.

Researchers found no differences in the percentage of participants using emergency services, general medical services, mental health services, occupational assistance, and housing services between alcohol use categories (P > .05 for all).

“Within patients with schizophrenia who are receiving outpatient treatment, rates of alcohol misuse are substantial (7.4%), but lower than might have been expected,” the researchers wrote. “In any case, patients who are misusing alcohol are at elevated risk for poor medication adherence, illicit drug use, more severe psychosis, and worse quality of life. Targeted dual diagnosis treatment services are needed for these individuals to assist them with symptom reduction and improvement in daily functioning. In addition, patients who drank any alcohol also had lower rates of use of medical services, compared with nonusers. While outreach efforts are needed for misusers, such efforts may also benefit veterans with schizophrenia who drink at any level.” – by Amanda Oldt

Disclosure: Please see the study for a full list of relevant financial disclosures.