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Muhammad Shakeel
Akhtar Ali


Objective: To determine the frequency and pattern of substance misuse in patients with schizophrenia

Methodology: A total of 425 patients with schizophrenia, as per International Classification of Diseases Re­search criteria version 10 (ICD-10), were included in this cross sectional study from Sarhad Hospital for Psychi­atric Diseases Peshawar from September 2020 to February 2021. Patients Information was gathered through a semi-structured questionnaire. Frequency and percentage for categorical variables while mean and standard deviation for continuous variables were calculated using SPSS version 24.

Results: Out of 425, 84.9% are males while 15.1% are females. Mean ages of onset of schizophrenia and sub­stance misuse are 21.97+6 years and 17.99+7 years respectively. Age of onset of schizophrenia and substance misuse in males is 21.97+6.01 years and 17.99+7.06 years while in females it is 24.12+8.07 years and 19.45 +4.42 years respectively. Life time history for any substance misuse is 69.6%, tobacco 68.2% and non-tobacco substances 41.2%, cannabinoids 40.8%, opioids 5.2%, stimulants 5.7%, sedative hypnotics 2.6% and other substances 0.2%. 54.4% started substance misuse before the onset of schizophrenia while 12.5% started after the onset of schizophrenia. 65.9% are still (presently) misusing any substance, 65.4% are still misusing tobacco while 26.1% are still misusing non-tobacco substance. Substance misuse was more among uneducated, single and male patients.

Conclusion: Substance misuse is quiet common among schizophrenic patients and its onset usually precedes the onset of schizophrenia. Onset of schizophrenia and substance misuse is earlier in males as compare to females. Moreover frequency of substance misuse is lower in female patients, those who are educated and those who are married and vice versa.

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How to Cite
Shakeel M, Adeela, Ali A. FREQUENCY AND PATTERN OF SUBSTANCE MISUSE IN PATIENTS WITH SCHIZOPHRENIA. J Postgrad Med Inst [Internet]. 2021 Dec. 31 [cited 2022 May 24];35(4):247-50. Available from:
Original Article


Gelder M, Harrison P, Cowen P. Shorter Oxford textbook of psychiatry. 7th ed. London: Oxford University Press; 2018. 252–72 p.

Iyegbe C, Campbell D, Butler A, Ajnaki¬na O, Sham P. The emerging molecular architecture of schizophrenia, polygenic risk scores and the clinical implications for GxE research. Soc Psychiatry Psy¬chiatr Epidemiol. 2014;49(2):169–82.

Crockford D, Addington D. Canadian schizophrenia guidelines: schizophrenia and other psychotic disorders with co¬existing substance use disorders. Can J Psychiatry. 2017;62(9):624–34.

Nielsen SM, Toftdahl NG, Nordentoft M, Hjorthøj C. Association between al¬cohol, cannabis, and other illicit sub¬stance abuse and risk of developing schizophrenia: a nationwide population based register study. Psychol Med. 2017;47(9):1668.

Helle S, Ringen PA, Melle I, Larsen T-K, Gjestad R, Johnsen E, et al. Can¬nabis use is associated with 3 years earlier onset of schizophrenia spec¬trum disorder in a naturalistic, multi-site sample (N=1119). Schizophr Res. 2016;170(1):217–21.

Barnes TRE, Mutsatsa SH, Hutton SB, Watt HC, Joyce EM. Comorbid substance use and age at onset of schizophrenia. Br J Psychiatry. 2006;188(3):237–42.

Mueser KT, Yarnold PR, Levinson DF, Singh H, Bellack AS, Kee K, et al. Preva¬lence of substance abuse in schizophre¬nia: demographic and clinical correlates. Schizophr Bull. 1990;16(1):31–56.

Hunt GE, Large MM, Cleary M, Lai HMX, Saunders JB. Prevalence of comorbid substance use in schizophrenia spec¬trum disorders in community and clin¬ical settings, 1990–2017: systematic review and meta-analysis. Drug Alcohol Depend. 2018;191:234–58.

Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G. Substance abuse in patients with schizophrenia. Dialogues Clin Neu¬rosci. 2006;8(1):37.

Sadock BJ, Sadock BJ, Sadock VA RP. Kaplan & Sadock’s synopsis of psychia¬try: behavioral sciences/clinical psychi¬atry. 11th ed. Philadelphia: Lippincott Williams & Wilkins.; 2018. 800 p.

Duke PJ, Pantelis C, McPhillips MA, Barnes TRE. Comorbid non-alcohol substance misuse among people with schizophrenia: epidemiological study in central London. Br J Psychiatry. 2001;179(6):509–13.

Verweij KJH, Abdellaoui A, Nivard MG, Cort AS, Ligthart L, Draisma HHM, et al. Genetic association between schizo¬phrenia and cannabis use. Drug Alcohol Depend. 2017;171:117–21.

Häfner H, an der Heiden W. Epidemiol¬ogy of schizophrenia. Can J Psychiatry. 1997;42(2):139–51.

Mauri MC, Volonteri LS, De Gaspari IF, Colasanti A, Brambilla MA, Cerru¬ti L. Substance abuse in first-episode schizophrenic patients: a retrospective study. Clin Pract Epidemiol Ment Heal. 2006;2(1):1–8.