The course of schizophrenia is determined by a number of factors, which have been relatively well studied. For example, long-term outcome is usually better for men than for women, a later age of onset predicts a better long-term course; and early cognitive and intellectual impairments are associated with poorer course.
Comorbid psychiatric conditions and syndromes represent another added burden that negatively affect outcome. Methodological problems beset the researcher who studies these questions. First, long-term studies are rare and often patients with comorbid conditions are specifically excluded. Second, with the exception of substance and alcohol abuse and dependence, comorbid syndromes are not routinely identified. Third, examination of differential long-term outcome specifically for patients with and without comorbid conditions is even rarer than long-term studies.
This presentation will review data specifically regarding substance and alcohol abuse as a model for studies that can inform us regarding outcome with comorbid conditions in schizophrenia.
Finally, recommendation regarding strategies to ascertain the influence of comorbid conditions on long-term outcome will be proposed.