Management of Chronic Mental Illnesses and Substance Use Disorders

There is vast literature available about prevalence and pattern of substance use in patients with Chronic mental illness such as Schizophrenia. Many of these studies have also investigated the issues related to the impact of substance use on the course and prognosis of the mental illness and vice versa. The factors affecting the use and its impact on treatment have also been studied to some extent in the Western countries. Estimates of the prevalence of substance abuse in schizophrenia and major affective disorder vary as a function of settings (e.g., community, hospital-in-patient vs. out-patient), demographic characteristics of the sample and assessment methods, with most prevalence rates ranging between15% to 65%. Patients with Chronic Mental illnesses and Substance use disorders are difficult to treat and many models for their management have been proposed. This chapter will deal with some of these issues.