However, a three-year study revealed patients generally achieved remission from substances of abuse, with schizophrenia-spectrum disorder patients faring less well in terms of hospital readmission compared to patients with bipolar disorders [12, 16]. An investigation of adults with bipolar disorders associated persistent substance use with poorer functional outcomes [33], and similar research associated alcohol use with increased symptoms of depression for females but not for males [35]. A similar study associated persistent alcohol abuse with chronic course of depressive illness for females but not for males [34]. Indeed, heterogeneity in demographic, clinical and substance use characteristics can have a profound influence on the recovery of persons with different SMIs, which may signal sub-samples of patients at risk for addiction related problems, thus having implications for treatment.
