Substance use diagnoses and discharge patterns among psychiatric inpatients

Over a four-month period, 113 consecutive admissions to a general psychiatric ward of a Veterans Affairs hospital were evaluated for the presence of a substance use diagnosis as well as type of discharge (regular or irregular). Of the patients studied, 61 percent had a substance use diagnosis and 57 percent received an irregular discharge. Although there was some increase in the rate of irregular discharges among substance users, logistic regression analysis showed the increase was not significant. There was no difference between substance users and nonusers in length of stay. However, younger age and axis II pathology were associated with irregular discharge, and younger age was associated with shorter length of stay. Because an irregular discharge implies an undesirable treatment outcome, future studies should focus on identifying and providing optimal treatment of those patients at risk for irregular discharge.