The co-morbidity of substance use disorders and other psychiatric disorders among patients admitted at Butabika hospital.

Abstract

BACKGROUND: Research done mainly in europe and north ameria has shown high rates of co-morbidity substance use disorders among patients admitted with primary psychiatric disorders. These dual diadgnosis patients have been shown to have a more complex presentation, are harder to manage and have poorer clinical and social outcomes. There is paucity of research on this category of patients in uganda and africa in general where the rates and patterns of substance abuse may be different from the rest of the world. OBJECTIVE: This study aimed at establishing the prevalence and pattern of substance misuse among patients admitted with primary psychiatric disorders as seen in Butabika hospital. STUDY DESIGN: This was a cross-sectional descriptive study METHOD: A total of 272 patients consecutively admitted to Butabika hospital over a two months period were recruited into the study. They were interviewed using a standard questionnaire that included the structured clinical interview for DSM-IV (SCID). RESULTS: Of the 272 respondents, 82 (30.2%) were co-morbid, 45 (16.5%) had a substance use disorder only and 145 (53.3%) had a primary psychiatric disorder only The prevalence of substance misuse among specific psychiatric disorders was variable with 42.1% in schizophrenia, 33.8% in bipolar affective disorders, 62.5% in anxiety disorders, and 33% in major depressive disorders. Alcohol was the most frequently abused substance in all the primary disorders, followed by cannabis and nicotine. The substance misusing patients were significantly young (p=0.003) and male (p<0.00). CONCLUSION: The results of this study highlight a high prevalence of substance misuse among patients admitted with primary psychiatric disorders. Mental healthcare providers need to be aware of such co-morbidity. Special interventions need to be developed for this category of psychiatric patients