chapter  12
14 Pages

The treatment of substance misuse in people with serious mental disorders

WithDavid J. Kavanagh, Kim T. Mueser

Extensive research has shown that individuals with serious mental illness such as schizophrenia, bipolar disorder, or treatment-refractory major depression are at substantially increased risk for co-occurring drug and alcohol use disorders. For example, most population surveys indicate lifetime rates of alcohol or drug misuse in the general population in the US, Europe and Australia of approximately 15 percent, compared with 40–50 per cent for people with serious mental illness. Vulnerability to substance misuse in people with serious mental illness is associated with many of the same factors as in the general population. Male gender, younger age, single marital status and lower education have all been related to a higher likelihood of substance use disorder in people with serious mental illness, as in the general population. Problems with substance use in the general population are defined in terms of continued use, despite a negative impact on the person's health, social or role functioning.