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Psychiatric consultation and substance use disorders.
Sheila Specker1, William H Meller1, Steven Thurber2
1Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
Substance Abuse : Research and Treatment
|December 21, 2013
Summary
Many hospital patients have substance use disorders (SUD) but are often unidentified. Early identification and intervention are crucial for effective treatment and improved patient outcomes in general hospital settings.
Area of Science:
- Psychiatry
- Consultation-Liaison Psychiatry
- Substance Use Disorders
Background:
- Many general hospital patients have undiagnosed substance use disorders (SUD).
- Failure to identify SUD can prevent patients from receiving necessary interventions.
- Referral-consultation processes often miss a significant number of patients with SUD.
Purpose of the Study:
- Evaluate all referred patients for potential substance use disorders (SUD).
- Assess diagnostic agreement between referrals for chemical problems and DSM diagnoses.
- Compare demographics of patients with and without SUD.
- Examine conditions co-occurring with SUD.
Main Methods:
- Reviewed 524 consecutive referrals to psychiatric consultation-liaison services over one year.
- Psychiatric consultants screened for chemically-related problems.
- Data included financial stressors and consultant recommendations.
Main Results:
- 176 referrals (33.6%) met criteria for SUD (57% alcohol, 25% other drugs, 18% both).
- Patients with SUD were younger, male, non-Caucasian, unmarried, and unemployed.
- Associated conditions included depression, gastrointestinal issues, trauma, and financial difficulties.
- Lower Global Assessment of Functioning (GAF) scores predicted inpatient referrals.
Conclusions:
- Findings align with previous studies on SUD in hospital settings.
- Despite identification, many patients with SUD likely remain unrecognized.
- Effective identification and treatment pathways are essential for improving patient care.
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