Occurrence of comorbid substance use disorders among acute psychiatric inpatients at Stikland Hospital in the Western Cape, South Africa

Abstract

Objective: Little is known about the epidemiology of substance use disorders (SUD) among psychiatric inpatients in the Western Cape, South Africa. Therefore, this study was conducted to examine the prevalence of SUD among acute adult psychiatric inpatients at Stikland Hospital, one of three state acute psychiatric hospitals in the Western Cape.

Method: A prospective descriptive prevalence survey was undertaken over a three-month period. During this period, data was collected on psychiatric patients (N=298) who were hospitalized in the acute psychiatric wards at Stikland. This included patient demography, psychiatric and substance use history. Urine was also collected and analyzed for substances commonly abused in the Western Cape.

Results: A co-morbid SUD (abuse or dependence) was diagnosed in 51% of patients. In addition, a diagnosis of a substance-induced psychiatric disorder was made in 8% of these patients, 1% of who was diagnosed with a substance-induced mood disorder, while 7% was diagnosed with a substance induced psychotic disorder. Patients diagnosed with a co-morbid SUD were younger than those without a SUD and more likely to have been involuntary admissions. These patients also displayed more violence prior to admission that contributed to their admission and were more likely to have used cannabis or methamphetamine as their preferred drug of abuse. Only a small group of patients had documented evidence of any prior interventions for their SUD.

Conclusion: SUD are prevalent among psychiatric inpatients and contribute to their morbidity. This has implications for staff training and service development.