Psychiatric comorbidity in patients with substance use disorder: A hospital-based study

Abstract

Background: Pattern of substance use, profile of substance users, and treatment-seeking differ across cultures and continents. These differences could potentially affect the pattern and perhaps prevalence of dual diagnosis. However, the study of dual diagnosis from de-addiction clinics in India is limited in number and methodology. In this study, we report the prevalence and patterns of psychiatric disorders in subjects attending a de-addiction clinic in a teaching hospital in Srinagar, Kashmir. Methodology: In this cross-sectional study, 300 subjects (>18 years of age) seeking treatment for substance use disorders were screened with Mini International Neuropsychiatric Interview Plus for the presence of psychiatric comorbidity. Subjects were assessed after 4 weeks of complete abstinence from psychoactive substances. Results: Cannabis (26%) was the most common single-use substance. It was followed by polysubstance use (22.3%) and opioids (21.3%). Among the 300 subjects assessed for the purpose of the study, 174 (58%) were found to have dual diagnosis. Psychotic disorders (34%) were the most common psychiatric comorbidity, and it was followed by major depressive disorder (16%) and bipolar affective disorder (16%). Posttraumatic stress disorder (PTSD) was present in 20 (11.5%) subjects. When the groups with or without dual diagnosis were compared, cannabis and benzodiazepine dependence was found to be significantly common in the dual diagnosis group. Conclusions: A high prevalence of dual diagnoses, especially psychotic disorders and also PTSD, in our predominantly cannabis-using subjects attending hospital located in a distinct sociocultural setting in India, highlights the importance of taking into consideration the sociocultural context in which substance use as well as dual diagnoses should be understood.