A recent study found that people with psychotic disorders are more likely to participate in "smoking, drinking and drug use" than the general population.
The findings are significant because people with severe mental illnesses are often die younger than those without a mental illness, a Washington University in St. Louis news release reported.
These patients tend to pass away much younger, with estimates ranging from 12 to 25 years earlier than individuals in the general population," first author Sarah M. Hartz, MD, PhD, assistant professor of psychiatry at Washington University. said in the news release. "They don't die from drug overdoses or commit suicide -- the kinds of things you might suspect in severe psychiatric illness. They die from heart disease and cancer, problems caused by chronic alcohol and tobacco use."
The research team analyzed substance abuse in 20,000 individuals; 9,142 of those subjects had been diagnosed with "schizophrenia, bipolar disorder or schizoaffective disorder -- an illness characterized by psychotic symptoms such as hallucinations and delusions, and mood disorders such as depression," the news release reported.
The team also looked at instances of these habits in 10,000 people who had been deemed mentally healthy.
The researchers found 30 percent of mentally ill patients study subjects participated in binge drinking (having more than four servings of alcohol in one sitting). Only eight percent of the healthy group binge drank.
About 75 percent of the subjects with severe mental illnesses smoked tobacco regularly, compared with 33 percent of those without a psychotic disorder. About 50 percent of the mentally ill patients used marijuana regularly compared to 18 percent of the general population. Recreational drugs were used by 50 percent of the individuals with mental disorders and only 12 percent of the comparative group.
"I take care of a lot of patients with severe mental illness, many of whom are sick enough that they are on disability," Hartz said. "And it's always surprising when I encounter a patient who doesn't smoke or hasn't used drugs or had alcohol problems."
The team found that race and gender had very little influence in the substance abuse rates of the mentally ill patients. Hispanics and Asians tend to have lower substance abuse rates than other races in studies on those without psychotic disorders.
"We see protective effects in these subpopulations," Hartz explained. "But once a person has a severe mental illness, that seems to trump everything."
The researchers hope to find if aggressively working to curb substance abuse in those with severe psychotic disorders could help lengthen their lives.
"Some studies have shown that although we psychiatrists know that smoking, drinking and substance use are major problems among mentally ill patients, we often don't ask our patients about those things," Hartz said. "We can do better, but we also need to develop new strategies because many interventions to reduce smoking, drinking and drug use that have worked in other patient populations don't seem to be very effective in these psychiatric patients."
