Prevalence and patterns of substance use amongst psychiatric inpatients at Helen Joseph Hospital
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.
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.