Schizophrenia and substance use problems: a comparisonbetween patients with and without significant carercontact.

AIM: Many researchers andclinicians in the mental health field have given much attention over thelast few years to patients with co-morbid problems of schizophrenia andsubstance use. This population is becoming a focus of attention for allservice providers owing to the suggested increase in numbers of patientswith these dual diagnoses and the observed negative effects on patientsand costs to services. The advantages for providing family interventionsin schizophrenia are now well established and increasingly theseinterventions are being evaluated for families of dual diagnosis patients.Many dually diagnosed patients do not, however, have a great deal ofcontact with a carer/relative. This paper looks at whether differencesexist between patients with a dual diagnosis that have carer contact andthose who do not have carer contact in terms of their illness history andtype of substance use. For the purpose of this article 'carer' refers toan individual who is an informal carer or relative with whom the clienthas weekly contact of 10 h. Many of these carers provide the client withemotional, physical and material support. METHOD: The identificationprocess for both'carer contact' and 'no carer contact' patients wasconducted through the screening of the hospital's care programme approach(CPA) lists and through contact with care coordinators and consultants.Case notes of all patients identified were screened and information ondemographic data, duration of illness, admissions and substance use wascollected. RESULTS: Results indicated that the 'no carer contact' groupwas older and had significantly more days in hospital at last admission.CONCLUSIONS: It is possible that as patients get older their contact withsignificant others decreases, i. e. loss of contact with key relatives isdue to age rather than severity of substance use. Furthermore, patients'reduced contact results in them having longer stays in hospital possiblybecause they will not receive additional support whendischarged.