Self-reported reasons for substance use in schizophrenia: A Q methodological investigation

Background: Large numbers of people with a diagnosis of schizophrenia use drugs and alcohol, resulting in poorer symptomatic and functional outcomes for many. Aims: To examine the reasons that people with a diagnosis of schizophrenia give for their own alcohol and drug use. Method: Q methodology was used to examine reasons for use. Forty-five people with a diagnosis of schizophrenia or schizoaffective disorder and comorbid substance misuse completed the sorting procedure. Results: Analysis of the Q Sorts revealed three distinct groups of substance users: (1) those who predominantly used for social and enhancement reasons, to 'chill out and have a good time with others:' (2) those who used to regulate negative affect and alleviate positive symptoms, to 'cope with distressing emotions and symptoms:' (3) those who used substances to augment themselves and intensify their experiences, to 'feel bigger, better and inspired.' Conclusion: People with a diagnosis of schizophrenia who use substances explain their substance use in different ways. The identification of subgroups of users may be useful in the development of interventions aimed at reducing substance use in this group.