Characteristics of Psychopathological Symptoms and Alcohol Craving in Patients with Paranoid Schizophrenia and Comorbid Alcohol Dependence under Different Antipsychotic Treatment Regimens

Koshkin E. A.
psychiatrist¹, postgraduate student²

Danilin I. E.
Ph.D. of Medical Sciences, Associate Professor²

1State Budgetary Healthcare Institution of the city of Moscow «Psychiatric Clinical Hospital No. 13 of the Department of Health of the City of Moscow
2Department of Psychiatry and Medical Psychology of the Patrice Lumumba Peoples' Friendship University of Russia

Egor Anatolevich Koshkin; e-mail: yago282@yandex.ru

The study was conducted without external funding.

The authors declare that there is no conflict of interest.

Background. Comorbidity of schizophrenia and alcohol dependence is associated with a more severe clinical course, frequent relapses, and reduced adherence to treatment. The choice of antipsychotic therapy in patients with a dual diagnosis remains challenging. Comparative data on the relationship between different antipsychotic treatment regimens, psychopathological symptoms, and alcohol-related behavior remain limited. Objective. To examine psychopathological symptoms, severity of alcohol dependence, and alcohol craving in patients with schizophrenia and comorbid alcohol dependence receiving different antipsychotic treatments. Materials and Methods. A cross-sectional observational study included 49 patients with paranoid schizophrenia (ICD-10: F20.0) and alcohol dependence syndrome. According to their main antipsychotic treatment, patients were divided into four groups: long-acting injectable antipsychotics, first-generation antipsychotics (haloperidol), second-generation atypical antipsychotics, and third-generation antipsychotics (aripiprazole or cariprazine). Psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), severity of alcohol dependence using the Alcohol Use Disorders Identification Test (AUDIT), and current alcohol craving using a visual analog scale (VAS). Nonparametric statistical methods were used for data analysis. Results. Differences between treatment groups were observed in AUDIT scores, alcohol craving (VAS), and the PANSS positive symptom subscale. Patients receiving haloperidol showed higher levels of alcohol dependence, stronger alcohol craving, and more pronounced positive symptoms. The lowest AUDIT and VAS scores were observed in patients treated with third-generation antipsychotics. Patients receiving long-acting injectable formulations and second-generation antipsychotics demonstrated intermediate values. Conclusions. Differences in psychopathological symptoms, alcohol dependence severity, and alcohol craving were observed across antipsychotic treatment regimens in patients with schizophrenia and comorbid alcohol dependence. Given the cross-sectional observational design, these findings reflect associations rather than causal effects and should be confirmed in prospective studies.

schizophrenia, alcohol dependence, dual diagnosis, antipsychotics, psychopathological symptoms, PANSS, AUDIT

10.29234/2308-9113-2026-14-1-120-130

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