Prevalence and patterns of substance use amongst psychiatric inpatients at Helen Joseph Hospital
Abstract
Background: Mental Disorders and Substance Use Disorders (SUD) commonly
occur together, termed dual diagnosis, this is associated with poorer functioning,
higher suicidality rates, hospitilisation, greater risk for crime and high health risk
behavior.
Methods: Cross-sectional study with a sample size of 150 participants, gathered
over 4 months. Data was collected with a structured clinical interview, and inpatient
hospital records. Alcohol and drug misuse was screened for using the AUDIT and
DUDIT respectively. A descriptive analysis was then made, prevalence of substance
misuse was determined, and comparisons were made between those with and
without substance misuse.
Results: The study group was predominantly young, single, african, unemployed
men. The leading presenting symptoms were psychosis, aggression and mania,
requiring mostly involuntary admissions, with a mean of 14 days hospital stay. Twothirds
of the participants were classified as substance misusers, these were
significantly younger men, more often brought to hospital by the police or
ambulance, and showed higher rates of substance use and substance-induced
disorders.
Conclusion: This highlights the benefit of using screening tools for diagnosing
substance use, and the need for improved management of those with a dual
diagnosis.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, in partial fulfilment of the requirements for the degree of
Master of Medicine in the branch of Psychiatry. Johannesburg
November 2017.