Substance related disorders in an inpatient psychiatric service: Prevalence descriptive study of abuse patterns and diagnostic profiles (Disturbi correlati a sostanze in un servizio psichiatrico di diagnosi e cura: Studio descrittivo di prevalenza su pattern di abuso e profili diagnostici)

Aim. To assess the prevalence of Substance Related Disorders and investigate the abuse patterns and diagnostic profiles occurring in patients admitted to the psychiatric unit of a university hospital; patients with exclusive alcohol abuse were not included in the study. Methods. The study was performed in 47 patients admitted to the San Matteo University Hospital of Pavia since January 1999 to December 2000, with a current or past history of Substance Related Disorders, according to DSM-IV criteria. Patients were administered an anamnestic form, whose design was based on the Addiction Severity Index.The diagnoses were assigned according to DSM-IV, axes I and II, and therefore were distributed into four diagnostic subgroups: A (Schizophrenia and Psychotic Disorders), B (Personality Disorders), C (Mood Disorders), D (No Psychiatric Diagnosis). Results. Cannabinoids, hallucinogens, alcohol and opiates were the election substances in over 50 percent of patients. In addition, more than half of the patients were polydrug abusers. Discussion. The prevalence of comorbidity for Substance Related Disorders in the index group, mainly represented by patients with Personality Disorders and Schizophrenia/Other Psychotic Disorders, was 9.5 percent. The severity profiles carried out among dually diagnosed patients underline the need of different service models, as indicated by previous treatment pathways, even if parallels, according to National Health Delivery System. Closer links between addiction and psychiatric services should consider and emphasise the well-established community mental health system