Researchers conduct largest ever assessment of substance abuse among the mentally ill


The link between mental illness and substance abuse has been long accepted as real, but not as substantiated or well-understood as it could have been. Researchers at the Washington University School of Medicine in St. Louis and the University of Southern California have published results from their study, the largest ever done, assessing substance abuse among those with severe psychiatric illness.

The study concludes that rates of smoking, drinking, and drug use are significantly higher among those with psychotic disorders than among the general population.

Published in the journal JAMA Psychiatry, the study showed concern with mortality rates and lower life expectancy among those with severe psychiatric disorders. All things exacerbated by substance abuse.

"These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population," said first author Sarah M. Hartz, MD, PhD, assistant professor of psychiatry at Washington University. "They don't die from drug overdoses or commit suicide—the kinds of things you might suspect in severe psychiatric illness. They die from heart disease and cancer, problems caused by chronic alcohol and tobacco use."

The study analyzed substance use in nearly 20,000 people, 9,142 of which were psychiatric patients diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. The control group were 10,000 people without mental illness diagnoses.

About thirty percent of those with severe psychiatric illness engaged in binge drinking (more than four servings at a time) compared to a general population rate of just eight percent. More than 75 percent of those with mental illness were tobacco smokers (versus 33 percent) and about half were marijuana users (versus 18 percent) and half were illicit drug users (versus 12 percent).

Hartz also noted that among those with psychotic illness, race and gender have little or no influence over whether they will become substance abusers.


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