Original Research

Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa

Ani Anic, Lesley J. Robertson
South African Journal of Psychiatry | Vol 26 | a1526 | DOI: https://doi.org/10.4102/sajpsychiatry.v26i0.1526 | © 2020 Ani Anic, Lesley J. Robertson | This work is licensed under CC Attribution 4.0
Submitted: 21 February 2020 | Published: 25 September 2020

About the author(s)

Ani Anic, Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa; and, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Lesley J. Robertson, Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa; Sedibeng District Health Services, Vanderbijlpark, South Africa


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Abstract

Background: Mental disorders and substance use disorders (SUD) commonly occur together, impacting healthcare outcomes. The diagnosis of substance use is often inadequate when comorbidity is present. It is vital to understand the prevalence of substance use amongst psychiatric patients to inform both clinical practice and service development in South Africa.

Aim: To ascertain the prevalence and clinical correlates of SUD amongst acute psychiatric inpatients.

Setting: The setting for this study was Helen Joseph Hospital acute psychiatric ward.

Methods: A cross-sectional study was conducted whereby consecutively admitted patients were invited to participate in a structured clinical interview utilising the alcohol use disorders identification test (AUDIT) and drug use disorders identification test (DUDIT) questionnaires. Statistical comparisons were made between those with and without SUD.

Results: Of 150 participants, 100 (67%) were identified with a SUD. Those with SUD were younger (p = 0.0010), more often male (p = 0.012), less likely to have a disability grant (p = 0.015) and more likely to be brought to hospital by police, ambulance or self than by a family member (p = 0.025). Almost half of people with bipolar disorder (47.3%) and schizophrenia (41.4%) had comorbid SUD. Twenty-three (15%) participants identified with SUD on questionnaire had been missed clinically. Only two participants were referred for inpatient substance rehabilitation on discharge.

Conclusion: Substance use disorders are highly prevalent amongst psychiatric inpatients. The AUDIT and DUDIT are potentially useful screening tools in routine clinical practice. Greater collaboration between psychiatric and substance rehabilitation services is recommended.


Keywords

substance use; AUDIT; DUDIT; Helen Joseph Hospital; mental disorders

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