Hazardous Substance Use among People with Psychiatric Disabilities Visiting Day Centers

Abstract

Objective: People who suffer from psychiatric illness have a more than doubled lifetime risk of acquiring an alcohol or drug use disorder. Furthermore, hazardous substance use impairs treatment outcomes and protracts the duration of illness among people with mental disorders. The aim of this study was to investigate substance use among people with psychiatric disabilities receiving municipality-based mental health services, any associations to socio-demographic and well-being variables, to diagnosis or to level of functioning, and any changes at a 15-month follow-up. Methods: One-hundred-and-twenty-three persons with psychiatric disabilities but no diagnosed substance use disorder participated and completed the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) at baseline and the follow-up. Self-report questionnaires were employed to estimate different aspects of well-being in terms of quality of life and self-rated health. Level of functioning and severity of psychiatric symptoms were assessed by the Global Assessment of Functioning (GAF) scale. Results: Nineteen percent of participants had hazardous use of alcohol (14%) or drugs (5%) at baseline, while 23% did not use alcohol and 89% did not use drugs. Since only few participants reported drug use, inferential analyses concentrated on alcohol use. Participants with a foreign origin and lower education were less likely to exhibit alcohol use, including hazardous alcohol use. Sex and age were unrelated to alcohol use, as were the wellbeing variables, level of functioning, symptom severity and self-reported diagnosis. Alcohol and drug use patterns were stable at the follow-up. Conclusion: The findings contribute with knowledge about hazardous substance use among people with psychiatric disabilities and indicate that preventive measures are warranted within the municipality-based mental health services. Staff in the municipality-based mental health services must stay alert on this issue and screening for hazardous use of alcohol and drugs should be considered.