Epidemiological studies usually have limited information
on clinical factors, particularly on treatment. Clinical
observations and considerations may complement
their results. If aggressive behavior in schizophrenia
patients is caused, for all practical purposes, by comorbid
substance use disorder, what would be its mechanism of
action? Acute pharmacological effects of alcohol,
cocaine, and other drugs may exacerbate psychiatric
symptoms such as hostility and further impair inhibitory
control of patients’ behavior. Furthermore, illicit drug
abuse is associated with aggression related to conducting
illicit transactions, need to obtain funds for drug purchases,
and similar criminogenic factors.