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 s...