ArticleActa psychiatrica Scandinavica2021
Morbidity and mortality in schizophrenia with comorbid substance use disorders.
Article in Acta psychiatrica Scandinavica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Cannabis use and suicide in people with a diagnosis of schizophrenia: a systematic review and meta-analysis of longitudinal, case control, and cross-sectional studies.Psychological medicine · 2025Pooled it
- Substance Use Within Trials of Psychological Interventions for Psychosis: Sample Inclusion, Secondary Measures, and Intervention Effectiveness.Schizophrenia bulletin · 2024Pooled it
- Place of the partial dopamine receptor agonist aripiprazole in the management of schizophrenia in adults: a Delphi consensus study.BMC psychiatry · 2022Pooled it
- Trial
- Education based on the theory of planned behavior to improve medication regimen adherence, hope and marital quality in patients with substance use disorder.BMC public health · 2024Trial
- Predictors of Mortality Following a Schizophrenia Spectrum Diagnosis: Evidence From the 20-Year Follow-up of the OPUS Randomized Controlled Trial.Schizophrenia bulletin · 2023Trial
- Examining Integration of Comprehensive Substance Use Services in Certified Community Behavioral Health Clinics: A Cross-sectional Study.Administration and policy in mental health · 2026Article
- Long-Acting Injectable Antipsychotics in Schizophrenia and Comorbid Substance Use Disorder: A Systematic Review of the Literature.Brain sciences · 2026Review
- Clozapine prescribing in Germany: temporal trends and regional variations, 2012-2022.Schizophrenia (Heidelberg, Germany) · 2026Article
- Determinants of hospital length of stay for schizophrenia: retrospective negative binomial analysis in a university hospital.BJPsych open · 2026Article
- Effects of occupational therapy on psychiatric symptoms and social functioning in patients with schizophrenia: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Review
- Adult psychiatrists' views on clozapine prescribing for schizophrenia in Germany-an online survey.Therapeutic advances in psychopharmacology · 2026Article
- The influence of social capital and evidence-based orientation on psychiatrists' attitudes toward antipsychotic polypharmacy in schizophrenia.Scientific reports · 2025Article
- Ritual to relief: ethical frontiers in repurposing psychoactive substances.CNS spectrums · 2025Review
- Cardiovascular protein profiling in patients with first-episode psychosis.Schizophrenia (Heidelberg, Germany) · 2025Article
- Psychoactive substance use among psychiatric in-patients presenting to the Emergency Centre of a district hospital in Cape Town, South Africa. A retrospective descriptive study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Review
- Association of substance use with suicide mortality: An updated systematic review and meta-analysis.Drug and alcohol dependence reports · 2025Review
- Certified Community Behavioral Health Clinic Services for Clients With Co-occurring Disorders: A Latent Class Approach.Psychiatric services (Washington, D.C.) · 2024Article
- Management of schizophrenia and comorbid substance use disorders: expert review and guidance.Annals of general psychiatry · 2024Review
- Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveSchizophrenia is highly comorbid with substance use disorders (SUD) but large epidemiological cohorts exploring the prevalence and prognostic significance of SUD are lacking. Here, we investigated the prevalence of SUD in patients with schizophrenia in Finland and Sweden, and the effect of these co-occurring disorders on risks of psychiatric hospitalization and mortality.
methods45,476 individuals with schizophrenia from two independent national cohort studies, aged <46 years at cohort entry, were followed during 22 (1996-2017, Finland) and 11 years (2006-2016, Sweden). We first assessed SUD prevalence (excluding smoking). Then, we performed Cox regression on risk of psychiatric hospitalization and all-cause and cause-specific mortality in SUD compared with those without SUD.
resultsThe prevalence of SUD ranged from 26% (Finland) to 31% (Sweden). Multiple drug use (n = 4164, 48%, Finland; n = 3268, 67%, Sweden) and alcohol use disorders (n = 3846, 45%, Finland; n = 1002, 21%, Sweden) were the most prevalent SUD, followed by cannabis. Any SUD comorbidity, and particularly multiple drug use and alcohol use, were associated with 50% to 100% increase in hospitalization (aHR any SUD: 1.53, 95% CI = 1.46-1.61, Finland; 1.83, 1.72-1.96, Sweden) and mortality (aHR all-cause mortality: 1.65, 95% CI = 1.50-1.81, Finland; 2.17, 1.74-2.70, Sweden) compared to individuals without SUD. Elevated mortality risks were observed especially for suicides and other external causes. All results were similar across countries.
conclusionCo-occurring SUD, and particularly alcohol and multiple drug use, are associated with high rates of hospitalization and mortality in schizophrenia. Preventive interventions should prioritize detection and tailored treatments for these comorbidities, which often remain underdiagnosed and untreated.
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