heroin and Schizophrenia

A sample of 15 patients participating in an injectable methadone trial and of 15 patients in an oral methadone maintenance treatment, who admitted injecting part or all of their methadone take-home doses, were compared to 20 patients in maintenance treatment who use methadone exclusively by mouth. The present study confirms the poorer general health, the higher levels of emotional, psychological or psychiatric problems, the higher use of illicit drugs, and the higher number of problems related to employment and support associated with the use of the intravenous mode of administration of methadone. As expected, due to the shunt of metabolism in the gut wall and of the liver first-pass effect, higher concentration to dose ratios of (R)-methadone, which is the active enantiomer, were measured in the intravenous group (23% increase). This difference reached an almost statistically significant value (P = 0.054). This raises the question whether the effect of a higher methadone dose could be unconsciously sought by some of the intravenous methadone users.

Topics: Administration, Oral; Adult; Brief Psychiatric Rating Scale; Depressive Disorder; Dose-Response Relationship, Drug; Employment; Female; Health Status; Heroin; Humans; Injections, Intravenous; Male; Methadone; Schizophrenia; Self Administration; Severity of Illness Index; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: Adult; Female; Heroin; Heroin Dependence; Humans; Male; Methadone; Middle Aged; Outcome Assessment, Health Care; Retrospective Studies; Schizophrenia

A considerable number of schizophrenic persons also abuse illegal drugs. This comorbidity raises problems of diagnosis which become particularly important when concerning forensic questions. The hypothesis of a distinct psychopathological syndrome of drug induced psychosis is widely criticized in the literature. A case report is presented to demonstrate the problems of differential diagnoses and the difficulties for psychiatric expertizing arising from these problems.

Topics: Adult; Cannabinoids; Commitment of Mentally Ill; Comorbidity; Expert Testimony; Heroin; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Male; Marijuana Abuse; Psychoses, Substance-Induced; Schizophrenia; Schizophrenic Psychology

First-degree relatives (FDRs) of 162 schizophrenic and 106 control probands were investigated [corrected]. Psychiatric morbidity was present in 34.8% of FDRs of schizophrenic probands and in 9.2% of FDRs of controls. There was significantly more psychiatric illness in the siblings and parents than in the offspring of both schizophrenic and control subjects. The morbidity risks for schizoid-schizotypal personality disorders, cannabis-use disorder and paranoid personality disorder were significantly higher in the FDRs of schizophrenic patients than in those of controls, suggesting a biological relationship.

Topics: Adolescent; Adult; Cannabis; Female; Heroin; Humans; Male; Middle Aged; Prevalence; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenic Psychology; Sex Factors; Substance-Related Disorders

Topics: Animals; Antipsychotic Agents; Buprenorphine; Cocaine; Female; Heroin; Humans; Macaca mulatta; Male; Obsessive-Compulsive Disorder; Schizophrenia; Substance-Related Disorders; Trichotillomania

The present study deals with pituitary-gonadal function in male heroin addicts, 6 patients with schizophrenia and 31 with mild personality disorders. We examined the serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone levels at the moment of hospitalization (at the maximum of heroin addiction), and 48 h and 10 days later. FSH levels were definitely reduced in all the patients and did not change during the period of heroin withdrawal. The LH levels were reduced to a lesser extent, but significantly, and did not change after 10 days of abstinence from the drug. Testosterone levels were very low and increased in the schizophrenics during withdrawal, but not in the other addicts. The possible influence of heroin addiction on catecholamine metabolism in the central nervous system and, therefore, on the hypothalamic releasing factor and pituitary gonadotrophins, and the peripheral effect on testicular function are discussed.

Topics: Adolescent; Adult; Follicle Stimulating Hormone; Heroin; Heroin Dependence; Humans; Hypothalamus; Luteinizing Hormone; Male; Personality Disorders; Pituitary Hormone-Releasing Hormones; Remission, Spontaneous; Schizophrenia; Testosterone; Time Factors

Topics: Adult; Alcoholism; Amphetamine; Barbiturates; Depression; Hallucinogens; Heroin; Humans; Male; Mental Disorders; Schizophrenia; Schizophrenia, Paranoid; Substance-Related Disorders

In a series of 103 psychotic patients with evidence of drug abuse, the following facts came to light. 1. A definitive diagnosis was made in 94%. In 6% of these cases the diagnosis remained unclear even after having been admitted for a second time. 2. Seventy-four percent (72 of 97) of the patients, who abused various drugs, usually in combination had organic psychoses, and 26% (25 of 97) were diagnosed as schizophrenics. 3. Of 36 patients, who suffered psychotic episodes due to the abuse of cannabis, or LSD, or heroin, 21 (= 58%) were schizophrenics. 4. In those cases showing organic psychoses, thought insertion, thought withdrawal, and thought broadcasting were not found. However all other first- (and second-) rank symptoms (Kurt Schneider) of schizophrenia were found. Perhaps this might be of help as a differential criterion. 5. The fact of drug abuse at the outset of a schizophrenia is dependent on the schizophrenic symptomatology. The use of and attitude to the drug as well as the experiencing of the drug's effects changes in the further course of the psychosis. This last point might also be of value in the differential diagnosis.

Topics: Analgesics; Cannabis; Heroin; Humans; Lysergic Acid Diethylamide; Neurocognitive Disorders; Schizophrenia; Substance-Related Disorders; Tranquilizing Agents

Topics: Amphetamine; Cannabis; Chromosome Aberrations; Drug Synergism; Female; Heroin; Humans; Lysergic Acid Diethylamide; Male; Phenothiazines; Radiation Effects; Schizophrenia; Substance-Related Disorders

Topics: Adolescent; Adult; Age Factors; Amphetamine; Barbiturates; Cannabis; Ethnicity; Family Characteristics; Female; Heroin; Humans; Intelligence Tests; Lysergic Acid Diethylamide; Male; Mental Disorders; New York; Personality Disorders; Psychological Tests; Schizophrenia; Sex Factors; Sexual Behavior; Social Class; Substance-Related Disorders

Topics: Adolescent; Adult; Aggression; Amphetamine; Barbiturates; Cannabis; Catatonia; Chronic Disease; Dissociative Disorders; Female; Heroin; Humans; Juvenile Delinquency; Lysergic Acid Diethylamide; Male; Paranoid Disorders; Personality Disorders; Psychoses, Substance-Induced; Schizophrenia; Social Class; Student Dropouts; Substance-Related Disorders