Anhedonia and social adaptation predict substance abuse evolution in dual diagnosis schizophrenia

Am J Drug Alcohol Abuse. 2008;34(1):75-82. doi: 10.1080/00952990701764631.


The current study sought to identify the variables, derived from the self-medication hypothesis, which predicted substance abuse evolution during a homogeneous 3-month antipsychotic treatment. Twenty-four patients were diagnosed with schizophrenia and substance abuse (mainly cannabis and alcohol). Substance abuse, psychiatric symptoms, anhedonia, and social adjustment were assessed at baseline and study endpoint. Linear regression analyses were performed. Better social adaptation and worse anhedonia predicted substance abuse improvements. Conversely, greater psychoactive substance (PAS) use predicted endpoint positive and depressive symptoms. These results suggest that: (i) substance abuse interferes with psychiatric prognosis in schizophrenia; and (ii) dual diagnosis treatments leading patients to engage in alternative social activities may render substance abuse less appealing. Further studies are warranted to dissociate the causes and consequences of substance abuse in schizophrenia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affective Symptoms / diagnosis*
  • Affective Symptoms / epidemiology
  • Affective Symptoms / psychology*
  • Alcohol-Related Disorders / diagnosis
  • Alcohol-Related Disorders / epidemiology
  • Alcohol-Related Disorders / psychology
  • Antipsychotic Agents / therapeutic use
  • Attitude
  • Behavior, Addictive / psychology
  • Comorbidity
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Humans
  • Male
  • Marijuana Abuse / diagnosis
  • Marijuana Abuse / epidemiology
  • Marijuana Abuse / psychology
  • Models, Psychological
  • Motivation
  • Prognosis
  • Psychotropic Drugs / adverse effects
  • Regression Analysis
  • Schizophrenia / diagnosis*
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Self Medication / psychology
  • Social Adjustment*
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / epidemiology


  • Antipsychotic Agents
  • Psychotropic Drugs