Abstract

Patients with substance use disorders (SUD) represent a significant part of psychiatric emergency. However the clinical characteristics of this population have been poorly documented. The Crisis-unit of the CHR Citadelle (Liège, Belgium) has been admitting patients with SUD for short emergency stays since 2003. We investigated personality and electrophysiological patterns in Crisis-unit inpatients, as a function of socio-demographic and clinical characteristics (comorbidities, substance of choice). We aim to describe psychiatric emergency patients with SUD and highlight common and distinct patterns, in order to improve the understanding and treatments provided to this population. 2062 inpatients with a diagnostic of substance abuse or substance dependence (978 males, mean age=35.9) were admitted between 2005-2013; 1262 fulfilled the TCI-R personality questionnaire and 1115 completed an event-related potential examination. The prevalence of axis-1 disorders other than SUD was 39%, and 46% for axis-2 disorders; 31% of the patients presented either slowed reaction time and/or electrophysiological abnormalities. Low selfdirectedness was found in patients with SUD regardless the presence of comorbidities and the substance of choice. However, other personality dimensions (novelty seeking, harm avoidance, reward dependence and self-transcendence) as well as electrophysiological examination show specific patterns as a function of these characteristics. Low selfdirectedness is confirmed as a major predictor of poor psychosocial functioning including SUD, stressing the major importance in mental health of self-responsibility, purposefulness and one's ability to regulate and adapt his/her behavior to the situation in accord with his/her goals and values.

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