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Substance use is a clinical comorbidity resulting in poor prognosis, non-adherence and increased admissions in schizophrenia and related disorders. This study investigated differences in treatment preferences in hospitalized schizophrenia and schizoaffective disorder patients with or without substance use. Retrospective recordings regarding patients hospitalized between July 2017 and July 2018 were obtained from a mental health hospital database. Younger people and males were prevalent in those reporting substance use. Total and involuntary hospitalization numbers were similar across groups. Admission to a psychiatry unit due to forensic issues was higher in substance users. Electroconvulsive therapy (ECT), long-acting injection antipsychotics (LAI APs) and clozapine use were more frequent in substance non-users. Total and involuntary hospitalization numbers predicted LAI AP use, while younger age, total hospitalization and illness duration predicted clozapine use. Substance use was predictive for clozapine use. Substance use should be monitored in young, male cases with schizophrenia spectrum disorders. LAI AP, clozapine, and ECT use should be investigated more comprehensively in this group.

Investigating differences of medications in hospitalized schizophrenia and schizoaffective disorder patients: impact of substance use