BACKGROUND: About half of all schizophrenic patients have a co-occurring substance use disorder, leading to poorer social and functional outcomes than obtained in non-abusing patients. To improve outcomes, integrated treatments have been designed that address the two conditions simultaneously. Results are, however, conflicting because the available effect studies are hampered by various methodological issues, among which are heterogeneous patient samples. METHODS: In this comparative study, two well-described patient samples diagnosed with schizophrenia and co-morbid substance abuse disorders either received an integrated treatment (IDDT) or treatment as usual (TAU). RESULTS: Patients in the IDDT condition showed significant reductions in illicit drug and alcohol use, improvements on all psychiatric symptom domains, reported higher quality of life and improved on social and community functioning. In contrast, patients' improvements in the TAU group were moderate and limited to a few substance use and psychiatric outcomes. The TAU group had significantly higher dropout rates 6 and 12 months after baseline, suggesting that the IDDT programme was more successful in committing patients. CONCLUSIONS: Our results suggest that an integrated approach to schizophrenic patients and co-morbid substance use disorders is superior to standard treatment and may be considered as the treatment of choice for this patient group.
BACKGROUND: About half of all schizophrenicpatients have a co-occurring substance use disorder, leading to poorer social and functional outcomes than obtained in non-abusing patients. To improve outcomes, integrated treatments have been designed that address the two conditions simultaneously. Results are, however, conflicting because the available effect studies are hampered by various methodological issues, among which are heterogeneous patient samples. METHODS: In this comparative study, two well-described patient samples diagnosed with schizophrenia and co-morbid substance abuse disorders either received an integrated treatment (IDDT) or treatment as usual (TAU). RESULTS:Patients in the IDDT condition showed significant reductions in illicit drug and alcohol use, improvements on all psychiatric symptom domains, reported higher quality of life and improved on social and community functioning. In contrast, patients' improvements in the TAU group were moderate and limited to a few substance use and psychiatric outcomes. The TAU group had significantly higher dropout rates 6 and 12 months after baseline, suggesting that the IDDT programme was more successful in committing patients. CONCLUSIONS: Our results suggest that an integrated approach to schizophrenicpatients and co-morbid substance use disorders is superior to standard treatment and may be considered as the treatment of choice for this patient group.