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. 2025 Jun:186:322-330.
doi: 10.1016/j.jpsychires.2025.04.006. Epub 2025 Apr 10.

Substance use and psychiatric comorbidities among medical inpatients: associations with length of stay, health-related quality of life, and functioning, with consideration for gender

M T Pons-Cabrera  1 , E Caballería  2 , L Navarro-Cortés  3 , R Borràs  4 , P Barrio  5 , J Manthey  6 , A Batalla  7 , C Oliveras  5 , M Sagué-Vilavella  8 , M Balcells  5 , L Pintor  9 , H López-Pelayo  10
Affiliations

Substance use and psychiatric comorbidities among medical inpatients: associations with length of stay, health-related quality of life, and functioning, with consideration for gender

M T Pons-Cabrera et al. J Psychiatr Res. 2025 Jun.

Abstract

Little is known about the impact of substance use and psychiatric comorbidities on the management and outcomes of medical inpatients. This study explores the influence of psychiatric comorbidities, and substance use (tobacco, alcohol, and cannabis) on the length of hospital stay (LOS), Health-Related Quality of Life (HRQoL), and functioning in 800 medical inpatients at a high-complexity academic hospital. Multivariate analyses demonstrated that psychiatric comorbidities were associated with reduced HRQoL (β = -0.050, p-value = 0.017), and impaired functioning (β = 3.4, p-value <0.001). High-risk tobacco, alcohol, and cannabis use, according to the ASSIST were independently associated with impaired functioning. High-risk alcohol use was furthermore associated with longer stays (RR = 1.5, p-value <0.001). Female gender was associated with poorer HRQoL and functioning outcomes but with shorter LOS. These findings underscore the necessity of integrated mental health care within medical settings and emphasize the importance of a comprehensive approach considering psychiatric comorbidities, substance use, and gender perspective.

Keywords: Functioning; Length of stay; Multimorbidity; Psychiatric comorbidities; Quality of life; Substance use.

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Conflict of interest statement

Declaration of competing interest MTP has received financial support for CME activities and travel funds from Lundbeck, Pfizer, and Esteve, outside the subject of this article; LNC has received financial support for CME activities and travel funds from Rovi and Casen-Recordati, which had no bearing on the research of this study; CO has received travel grants from Lundbeck, which had no bearing on the research of this study; MSV has received financial support for Declaration of Interest Statement CME activities and travel funds from Janssen-Cilag, Lundbeck, Rovi and Casen Recordati over the last three years, and reports no financial or other relationship relevant to the subject of this article; MB has received travel grants from Lundbeck and Camurus and CME-related honoraria from Novo Nordisk, all outside the subject of this article; HLP has received honoraria from Advanz, and travel grants and support for CME activities from Lundbeck, which had no bearing on the research of this study. All the authors declare no competing interests related to this work.