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Research code: مقاله مستقل پژوهشی
Ethics code: IR.IAU.MSHD.REC.1400.030
Clinical trials code: مقاله مستقل پژوهشی

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Department of Psychiatry, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran , v.saadatian@gmail.com
Abstract:   (145 Views)
Abstract
Introduction
Addiction is a physical, mental, and social disease (1) in which multiple factors such as genetics, beliefs, unconscious processes, and mood are involved as well as developmental, social, economic, and political factors (2). Addictive and substance-related disorders have become a public concern worldwide. In fact, according to the statistics of the United Nations Office on Drugs and Crime, between 4 and 7 million people in Iran were infected with illegal addictive substances in 2003 (3).
Mental disorder is a type of illness with psychological and behavioral manifestations accompanied by disturbance in functioning caused by a biological, social, psychological, genetic or chemical disorder (7). In general, addiction and substance-related disorders are defined as a state in which a person continues to consume a substance that causes mood or behavioral changes, or suffers from neurological disorders, despite the symptoms and adverse consequences of drug use. It is derived from those behaviors (7).
Comorbidities (multiple disorders) of psychiatric disorders and drug use is a very tangible and widespread problem (8). In particular, substance use disorder in individuals with schizophrenia shows a high degree of comorbidity (9), as does substance use disorder (SUD) in populations suffering from mood disorders (10), showing a prevalence of more than 50%. For people with bipolar disorder (BD) there is substance use (11).
Substance use in both schizophrenia and bipolar disorder is associated with a more severe course and outcome. Stimulant substance use is associated with crime, violence, and homelessness in severe mental disorders, and high levels of cannabis use are associated with increased psychopathology in schizophrenia and bipolar disorder. Alcohol consumption is associated with depression in bipolar disorder. The use of multiple substances (simultaneous use) in substance use disorder is associated with schizophrenia (17). Little is known about substance use patterns and rates of use in severe mental disorders. Increasing knowledge about substance use problems for these two disorders could improve phenotypic characterization and thereby clarify the nature of the conditions. A complete description of the patient along with a detailed description of substance use can also reveal new aspects of the condition necessary to improve the treatment of these complex clinical conditions. In these patients, it seems necessary. Therefore, researchers are trying to answer the question of whether there is a difference between substance problems in schizophrenic and bipolar patients admitted to Ibn Sina Hospital in Mashhad.
Method
This study is descriptive and analytical cross-sectional. The research population included patients suffering from schizophrenia or bipolar disorder with substance use disorder admitted to Ibn Sina Hospital in Mashhad in 1400, in the number of 40 male patients, provided they met the criteria for entering the research. Since this was done for the first time, it was planned to be a pilot study and 20 patients in each group. The participants were selected based on available sampling and were examined by a psychiatrist, and the diagnosis of schizophrenia or bipolar disorder was made for the patients, and after a full explanation of the plan, they entered the plan with informed consent. In this study, PASUPP questionnaire was used to evaluate the study population. In the data analysis, the normality of the data was first checked using the one-sample Klomogrov-Smirnoff test. Chi-square test was used in the analysis of nominal scale data. Also, Pearson's correlation test was used to check the linear relationship between quantitative variables due to the normal distribution of data, and Spearman's correlation test was used to check the linear relationship between quantitative and rank variables.
Results
The results showed that there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients. (P-Value>0.05). Another finding showed that there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients according to age. (P-Value>0.05). It was also found that there is no significant linear relationship between age and the score of problems related to substance dependence in bipolar patients (P-Value>0.05), but in the group of schizophrenic patients, there is a relationship between age and the score of problems related to substance dependence in schizophrenia patients. There is a direct significant line with medium intensity (P-Value < 0.05) so that in these patients, as the age increases, problems related to substance dependence also increase. Also, the results showed that there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients according to education. (P-Value>0.05). Finally, it was found that there is no significant linear relationship between the level of education and the score of problems related to substance dependence in both groups of bipolar and schizophrenia patients (P-Value>0.05).
Discussion
According to the data obtained from this study, in terms of gender distribution in the studied subjects, all subjects in both groups of patients were male. In the group of schizophrenic patients, there is a direct significant linear relationship between age and the score of problems related to substance dependence in schizophrenia patients with moderate severity, so that with increasing age, problems related to substance dependence also increase in these patients. Also, there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients. Also, there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients according to age. In the following, we will examine similar studies and examine their results.
Suicide attempt, poor compliance, longer hospitalization, shorter recovery and criminal activity were also observed more in the group of patients with bipolar disorder and SUD. The presence of a substance use disorder seems to have more statistical weight than the main diagnosis (schizophrenia vs. bipolar disorder) in predicting worse social adjustment (22).
 
     
Type of Study: Research | Subject: Psychiatry

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