What is the relationship between schizophrenia and addictions?

We explore the link between schizophrenia and drug abuse and dependence.

Although psychiatric diseases and psychological disorders are defined and delimited in diagnostic manuals, beyond the pages the reality is that, in practice, there are many pathologies that overlap with each other in several aspects.

Thus, for example, there are symptoms that can be characteristic of depression and bipolar disorder, and only a global vision of the mental processes and behavior of a patient allows us to distinguish which is the disorder that affects him/her.

But these blurred boundaries between pathologies are present even in the dividing lines that separate disorders that resemble virtually nothing. For example, this is what happens when it is observed that a large proportion of people who develop one disease also develop the other... something that happens with schizophrenia and addictive disorders.

In this article we will explore the issue of what the relationship is between schizophrenia and drug addictionsand what implications this has on the treatment of these pathologies.

What is schizophrenia?

Schizophrenia is a mental illness suffered by approximately 0.5% of the general population at some point in their lives, being the most common psychotic disorder.. Although it can be expressed for the first time during childhood or adolescence, its symptoms usually begin to manifest themselves between the ages of 25 and 30.

As a pathology linked to the spectrum of psychotic disorders, schizophrenia is associated with the concept of a break with reality; that is, those who develop it suffer severe alterations in basic processes for personal autonomy, such as the perception and interpretation of facts, and the management of thoughts and emotions. These symptoms are not always present, but are expressed throughout "crises", although in some cases the onset and end of these episodes may be gradual and not too well defined.

In addition to being varied, the symptoms of schizophrenia can be divided into two types: positive symptoms and negative symptoms.. The former include the set of alterations characterized by the presence of strange elements in the person's way of thinking or perceiving things: hallucinations and delusions, mainly. Negative symptoms are characterized by the lack of elaboration or intention in psychological processes necessary to live adequately in society and have a good quality of life, such as the deficit of emotional response to important events, the poor use of language, or the persistent tendency to social isolation.

This set of symptoms has internal and external causes, and many of them can be facilitated by the social dynamics around the person (the clearest example being social isolation).

In any case, another of the characteristics of schizophrenia is its destabilizing character in people's lives, which is associated with a higher rate of social isolation.It is associated with a greater predisposition to develop other psychiatric illnesses or psychological disorders.

What is the link between addictions and schizophrenia?

As we have already mentioned, there is ample evidence that people with one or more drug addictions (with poly-drug addiction) are over-represented among those who have developed schizophrenia. That is, that among people with a diagnosis of schizophrenia, the proportion of people with addictions to psychoactive substances is much higher than the average for the general population. general population. Thus, while approximately 16% to 20% of the population has developed an addictive disorder towards a drug (legal or illegal), among those diagnosed with schizophrenia this percentage rises to 47%. The drugs most commonly consumed by this segment of the population after tobacco are alcohol, cannabis and cocaine.

The implications of this phenomenon are serious, because although addictive disorders are already pathologies that should be treated as soon as possible, drug abuse and dependence means that statistically people with schizophrenia are more likely to suffer psychotic crises, to not comply with the doctor's instructions or to abandon treatment, to adopt violent behavior patterns, to lose autonomy, and to develop suicidal ideation, among other things. In addition, this group of patients is more likely to relapse into drug use after having tried to overcome addiction.

Thus, drug use makes the development of schizophrenia worse, but also creates the circumstances for the person to develop other psychological disorders (as for example the depressive disorders) that are derived from the accumulation of problems and behavioral and emotional maladjustments generated by that combination of pathologies.

What are the causes of this relationship between diseases?

To date, the causes of this relationship between schizophrenia and drug addiction are still not known in great detail; that is to say, the causal mechanisms behind this overlap remain relatively hidden. In any case, the scientific consensus is that there is no single cause, but rather a combination of several interacting biosocial factors..

However, in recent years, several hypotheses have been suggested on the basis of increasing empirical evidence. One of them is the hypothesis of self-medication in people with schizophrenia, according to which those who develop this disease try to incorporate elements into their nervous system that help them to reestablish a certain balance in the chemical imbalance generated by schizophrenia. Thus, the use of drugs would be a semi-conscious way of "counteracting" the neuropsychological alterations from which the symptoms of schizophrenia arise. from which the symptoms of the pathology arise.

On the other hand, the hypothesis of genetic predisposition is also worth mentioning. According to this hypothesis, there are a series of genetic configurations that underlie both the propensity to develop schizophrenia and the propensity to become "hooked" on a drug.. In any case, the idea that both pathologies arise simply from the genetic code is denied; a combination of certain alleles would simply contribute to the appearance of these health problems, but would not be a determining element.

In addition, it is known that the use of certain drugs can eventually trigger a psychotic condition that consolidates into schizophrenia, so that once a person has been diagnosed with schizophrenia, he or she is likely to develop a psychosis.Once an addiction has been installed, it is easier for a predisposition to schizophrenia to manifest itself.

Looking for treatment for addictive disorders?

If you are looking for treatment for addictions with or without substances, contact our team of professionals.

At CITA Clinics we specialize in the intervention against this kind of pathologies, and we offer both outpatient care and complete detoxification, detoxification and rehabilitation treatments through admission in our residential module located in Dosrius (Barcelona). In our fully equipped facilities we work both from medicine and psychotherapy to make it possible for patients to leave the vicious circle of dependence and gain in health and quality of life, minimizing the risk of relapse.