The Role of Race in Admission to a Dual Diagnosis Unit Versus General Inpatient Psychiatric Unit in Those With Active Substance Use

IntroductionComorbidity between Substance Use Disorder (SUD) and other psychiatric disorders, known as Dual Diagnosis, is an issue of growing interest in Mental Health. The high association between Personality Disorders (PD) and substance use is reported in scientific literature. However, not many studies have been published regarding the prevalence of this disorder in a psychiatric unit. AIMSTo determine the prevalence of substance abuse among patients with a Personality Disorder in a psychiatric unit.MethodologyA retrospective descriptive study was carried out among all patients admitted to our psychiatric unit during one year. The data collected from the discharge clinical records of patients were: demographic variables, personal psychiatric history and substance use, urine tests and clinical diagnoses at discharge.ResultsWe obtained a sample of 334 patients. There was comorbidity between Mental Disorder and SUD in 10.17% of subjects; including 4% diagnosed with Personality Disorder (80% belong to Cluster B). 53.3% of patients with PD substance abuse was reported. Excluding nicotine dependence and benzodiazepines, the most common substances used were cannabis (50%), alcohol (37.5%) and cocaine (25%).ConclusionsThis study shows that Personality Disorder is the Mental Disorder most commonly associated with SUD, among inpatients in our psychiatric unit. In order to detect cases of Dual Diagnosis, we suggest optimize recording in clinical history substance use and systematic urine tests in all patients admitted, which would benefit from specific treatment for their condition.

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An audit of patient aggression in an adult psychiatric unit: 2013–2014

Australasian Psychiatry ◽

10.1177/1039856217726222 ◽

2017 ◽

Vol 26 (1) ◽

pp. 34-37 ◽

Cited By ~ 1

Author(s):

Claire Ewing ◽

Andrea Phillipou ◽

David Castle

Keyword(s):

Emergency Department ◽

Substance Use ◽

Patient Information ◽

Service Provision ◽

Odds Ratio ◽

Psychiatric Unit ◽

History Of ◽

Underlying Causes ◽

And Training

Objectives: The aim of this study was to determine the rates of patient aggression in a psychiatric unit over 12 months and to determine underlying causes, notably the role of substances. Methods: A retrospective file audit was undertaken of all patients admitted to St Vincent’s psychiatric unit (Melbourne, Australia) in the first half of 2013 and 2014 involved in an aggressive incident. Patient information included demographics, psychiatric, substance and aggression history. The setting and context of aggression and associated mental state findings were also reviewed. Results: There were 26 aggressive incidents in 2013 and 63 in 2014, perpetrated by 11 and 34 patients respectively. No significant differences were found between the groups’ baseline demographics. The 2014 cohort was significantly more likely to have substance use history (odds ratio (OR) 4.83) and have made threats to staff (OR 4.07) but significantly less likely to be distracted by internal stimuli (OR 0.05). There were also (not statistically significant) trends for the 2014 cohort; they were more likely to report a history of alcohol use (OR 3.9); be accompanied to emergency department by police (OR 2.95) and have leave prior to aggression ( χ2 = 7.37). Conclusions: Aggressive incidents more than doubled over 12 months. Substance use appeared to be a major factor associated with aggression. These findings have implications for service provision and training. Further research is needed to better understand and manage substances in psychiatric settings.

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The CAMP study: feasibility and clinical correlates of standardized assessments of substance use in a youth psychiatric inpatient sample

Child and Adolescent Psychiatry and Mental Health ◽

10.1186/s13034-021-00403-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Jillian Halladay ◽

Laurie Horricks ◽

Michael Amlung ◽

James MacKillop ◽

Catharine Munn ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Response Rate ◽

Self Report ◽

Youth Workers ◽

Psychiatric Unit ◽

Frontline Staff ◽

Clinical Correlates ◽

Electronic Assessment ◽

Inpatient Psychiatric Unit

Abstract Background To determine: (a) the feasibility and acceptability of administering a standardized electronic assessment of substance use and other mental health concerns to youth admitted to an inpatient psychiatric unit, and (b) the prevalence and clinical correlates of substance use in this sample. Methods The sample included 100 youth between the ages of 13 to 17 years admitted to an inpatient psychiatric unit in Ontario, Canada between September and November 2019 (78% response rate). Youth data were comprised of electronic self-reported assessments (during hospitalization and 6-months following) and chart reviews (99% consented; historical and prospective). Frontline staff completed a self-report survey assessing their perceptions of the need for standardized substance use assessments, training, and interventions on the unit (n = 38 Registered Nurses and Child and Youth Workers; 86% response rate). Analyses included descriptive statistics, correlations, regression, and qualitative content analysis. Results Feasibility of standardized youth self-reported mental health and substance use assessments was evident by high response rates, little missing data, and variability in responses. 79% of youth had used at least one substance in their lifetime; 69% reported use in the last 3 months. Substance use was positively correlated with severity of psychiatric symptoms (τb 0.17 to 0.45) and number of psychiatric diagnoses (τb 0.17 to 0.54) at index. Based on prospective and retrospective data, substance use was also positively related to mental health symptom severity at follow-up and repeat mental health related hospital visits. Frontline staff reported a need for standardized assessment, training, and interventions on the unit, indicative of acceptability. Conclusions This study demonstrated the feasibility, acceptability and clinical importance of administering a standardized mental health and substance use assessment among youth experiencing psychiatric hospitalization.

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Delusions Incorporating Cannabis use in Dually Diagnosed Patients with a Primary Psychotic Disorder

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670701634994 ◽

2007 ◽

Vol 41 (11) ◽

pp. 934-936

Author(s):

Sarah E. Flanders

Keyword(s):

Substance Abuse ◽

Psychotic Disorder ◽

Dual Diagnosis ◽

Cannabis Use ◽

Dually Diagnosed ◽

Psychiatric Unit ◽

Psychiatric Assessment ◽

Daily Observation ◽

Affective Content ◽

Inpatient Psychiatric Unit

Objective: To describe and discuss the implications for treatment of 3 cases of dually diagnosed patients with a primary psychotic disorder who have developed persisting, cannabis-oriented delusional systems. Method: Psychiatric assessment and daily observation on an acute inpatient psychiatric unit. Results: Abstinence appears to be particularly difficult to attain for a patient with psychosis who hold delusional beliefs that cannabis is a conduit for supernormal experiences with positive affective content, grandiose themes and a sense of enhanced self-efficacy. Conclusion: This phenomenon poses special challenges in the treatment of dual diagnosis patients. Modifications to existing CBT protocols for the treatment of substance abuse in psychosis might be useful in such patients.

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