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Open Access Highly Accessed Research article

“Clozapine makes me quite drowsy, so when I wake up in the morning those first cups of coffee are really handy”: an exploratory qualitative study of excessive caffeine consumption among individuals with schizophrenia

Lisa Thompson1*, Amy Pennay23, Adam Zimmermann1, Merrilee Cox1 and Dan I Lubman45

Author Affiliations

1 Neami National, 247 – 249 Rosanna Road, 3084 Rosanna, VIC, Australia

2 Centre for Alcohol Policy Research, Turning Point, Eastern Health, 54-62 Gertrude St, 3065 Fitzroy, VIC, Australia

3 Centre for Health and Society, School of Population and Global, University of Melbourne, 3052 Parkville, VIC, Australia

4 Turning Point, Eastern Health, 54-62 Gertrude St, 3065 Fitzroy, VIC, Australia

5 Eastern Health Clinical School, Monash University, 3168 Clayton, VIC, Australia

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BMC Psychiatry 2014, 14:116  doi:10.1186/1471-244X-14-116

Published: 16 April 2014

Abstract

Background

Research has shown that individuals with schizophrenia use caffeine at higher rates than the general population; however, no qualitative research has been undertaken investigating problematic caffeine use and its effects on this population. This article explores the role of caffeine consumption in the lives of people with schizophrenia through a narrative analysis of the attitudes and beliefs associated with this practice, and how these, in turn, influence caffeine consumption.

Methods

A qualitative study was undertaken with individuals who had previously scored in either a ‘moderate’ or ‘high’ risk category for caffeine use on the Alcohol, Smoking and Substance Involvement Screening Tool (ASSIST). In-depth interviews were undertaken with 20 individuals, and transcripts were analysed thematically to identify prominent perspectives.

Results

Consistent with previous literature, participants’ caffeine consumption was driven largely by its stimulating properties; however, participants also identified ‘cravings’ as an important motivating factor. Participants’ behaviours related to caffeine consumption seemed to be tempered by their previous experiences of consumption; if participants had experienced positive effects such as alertness or relaxation in the past, their use was maintained at a similar level or increased. Conversely, participants who anticipated negative consequences often altered their patterns of caffeine consumption; for example, by substituting caffeinated drinks that minimised or ceased their experience of negative side effects for those that directly caused such impacts. Overall, participants largely identified caffeine consumption as a highly meaningful activity, which provided structure to their day and facilitated opportunities for social interaction.

Conclusions

The inconsistencies between individuals’ beliefs about their health and the actual risk of harm associated with health-related behaviours present significant and ongoing challenges for the implementation of relevant and effective strategies for health promotion among individuals diagnosed with mental illness. As a starting point, it would be worthwhile for services engaging with people diagnosed with mental illness, and in particular schizophrenia, to consider implementing caffeine-related health literacy strategies to educate consumers about the risk of excessive caffeine consumption and the interactions between caffeine and antipsychotic medications.

Keywords:
Schizophrenia; Psychosis; Caffeine; Qualitative; Australia