Unraveling the Association Between Schizophrenia and Substance Use Disorder-Predictors, Mechanisms and Treatment Modifications: A Systematic Review

Anum Masroor; Arseni Khorochkov; Jose Prieto; Karan B Singh; Maduka C Nnadozie; Muhammad Abdal; Niki Shrestha; Rose Anne M Abe; Lubna Mohammed

doi:10.7759/cureus.16722

Unraveling the Association Between Schizophrenia and Substance Use Disorder-Predictors, Mechanisms and Treatment Modifications: A Systematic Review

Cureus. 2021 Jul 29;13(7):e16722. doi: 10.7759/cureus.16722. eCollection 2021 Jul.

Authors

Anum Masroor^{1

2

3}, Arseni Khorochkov⁴, Jose Prieto⁴, Karan B Singh⁴, Maduka C Nnadozie⁵, Muhammad Abdal⁶, Niki Shrestha⁵, Rose Anne M Abe⁵, Lubna Mohammed⁴

Affiliations

¹ Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
² Psychiatry, Psychiatric Care Associates, Englewood, USA.
³ Medicine, Khyber Medical College, Peshawar, PAK.
⁴ Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
⁵ Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
⁶ Emergency Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Abstract

Individuals with schizophrenia are particularly vulnerable to substance abuse problems. Comorbidity with substance use disorders (SUDs) frequently results in early death and increased dysfunction observed in schizophrenia. This dual diagnosis can be explained through multiple general mechanisms. Tobacco, alcohol, cannabis, and cocaine are substances widely used by individuals with schizophrenia. This study highlights the predictors, mechanisms responsible for the relationship between substance use disorder and schizophrenia and how it can help with the treatment of both disorders. The publications were rigorously reviewed after being found in multiple databases. The study's inclusion criteria were research published within the last five years, publications written in English, full-text availability, and human studies. A total of ten papers were selected for examination from a total of 9,106 articles found using the search method across several databases. This study follows the rules listed within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist 2009. The information gathered from these published studies was used to investigate the elements that contribute to the link between schizophrenia and substance abuse. Here, we evaluate a close relationship between schizophrenia and substance use disorders. The articles studied exhibit a bidirectional association between the two disorders in most individuals. From our analysis, the comorbidity between the two disorders is partially due to shared polygenic liability. Individuals with schizophrenia have dysfunctional Mesocorticolimbic brain reward circuits indicating a history of substance use. An underlying genetic vulnerability to schizophrenia may be triggered by extensive cannabis usage at a young age. A combination of psychological and pharmacological interventions for both disorders can significantly improve the outcome.

Keywords: cannabis use; drug addiction; gene-environmental; schizophrenia; substance use disorders.

Publication types

Review