Although previous research has identified characteristics that influence the recovery of persons with SMIs, improving outcomes is challenging [33, 36], and thus an investigation comparing the patterns of drug and alcohol use over time across patients with schizophrenia-spectrum, bipolar and depressive disorders is important. The present study sought to prospectively examine the longitudinal patterns of substance use in terms of recovery across a large and diverse sample of psychiatric patients. Accordingly, we followed 801 patients with schizophrenia-spectrum, bipolar and depressive disorders who participated in the MacArthur Violence Risk Assessment Study [37] for 1-year post-hospitalization, to examine: (1) longitudinal patterns in the proportion of patients using different substances; (2) diagnostic differences in the proportion of patients using substances; (3) associations between substance use, symptoms and functioning; and (4) diagnostic differences in the association between substance use, symptomatology and functional recovery.
