Psychiatric comorbidity among inpatients in an addiction clinic and its association with the process of addiction

Abstract

Objective: Epidemiological studies find a high comorbidity of other Axis I and Axis II disorders with substance use disorders among adults. This study examines comorbid Axis I and Axis II disorders in order to investigate their association with sociodemographic variables and relapse among inpatients diagnosed with substance use disorders. Method: Of 403 inpatients hospitalized between January 2012 and December 2013 in an addiction clinic, 323 were enrolled in this retrospective study using their medical records and sociodemographic data. These patients were all diagnosed with alcohol and substance abuse/dependence according to DSM-IV TR by two different psychiatrists, and comorbidities were also diagnosed by two different psychiatrists. Results: Among 323 inpatients with substance use disorder, 240 (74.3%) were diagnosed with another Axis I comorbidity and 238 (73.7%) had an Axis II disorder. No statistical difference was found between patients with and without an Axis I or Axis II comorbidity in terms of age, years of education, marital status, occupation, duration of drug use, rate of relapse in 6 months, and rate of dropout. Comorbidity of an Axis I and/or Axis II disorder raised the number of hospitalizations; comorbid Axis I disorder prolonged the duration of hospitalization, whereas Axis II disorder had an inverse effect. In addition, inpatients with an Axis II comorbidity had more legal issues and shorter duration until first use after treatment than inpatients without comorbidity. Conclusion: Comorbidity of substance use disorders and other Axis I and Axis II disorders is very common. Patients with dual diagnose use health services more often and have more legal issues than patients with substance use disorders only. Comprehensive care and treatment are needed for dual-diagnosed patients.