Characteristics of substance-abusing persons with schizophrenia: the paradox of the dually diagnosed

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Activities of Daily Living; Adult; Alcoholism; Combined Modality Therapy; Diagnosis, Dual (Psychiatry); Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia; *Schizophrenic Psychology; Social Adjustment; Substance-Related Disorders


Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology


Previous studies have noted the paradox of the dually-diagnosed (serious mental illness and substance abuse) in which the dually-diagnosed are judged to be both behaviorally more disorganized and simultaneously more socially competent. This study sought to further assess this paradox with a large sample size and a comprehensive assessment approach. In this study, the dually-diagnosed (N = 233) differed significantly from the non-dually-diagnosed (N = 262) in the symptom paradox. The dually-diagnosed were judged both more behaviorally disorganized and socially intact. The comprehensive assessment approach yielded empirical data in support of three possible hypotheses to explain the paradox. The implications of the findings and the three possible hypotheses are discussed.

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Citation: J Addict Dis. 2000;19(1):23-30.

Journal/Book/Conference Title

Journal of addictive diseases

Related Resources

Link to Article in PubMed

PubMed ID