Treatment Needs for Psychoactive Substance Use Disorders among Outpatients with Severe Mental Illness (SMI): A Comparative Study

Abstract

Introduction: Research has shown that persons with schizophrenia and bipolar affective disorder constitute a significant proportion of patients with severe mental illnesses who have a risk of substance use disorders. There are few previous studies directly comparing level of risk for drug related adverse treatment outcomes and treatment needs for substance use disorders in these two disorders. The aim of the present study was to compare level of risk and treatment needs for substance use disorders between patients with schizophrenia and those with bipolar affective disorder. Methods: Equal number of participants (n = 75 per group) with SCHIZ and BAD at the outpatient clinic of the Neuropsychiatric Hospital Aro were interviewed with a socio-demographic questionnaire and the Alcohol smoking and substance involvement screening test (ASSIST). Result: Patients with bipolar disorder had higher risk for adverse effects of pain medication use, while schizophrenia patients had higher risk of adverse effects of tobacco, cannabis, stimulants, alcohol and sedatives. Age, sex, marital status and level of education had significant associations with elevated risk for psychoactive substance use disorders. Conclusions: Adverse treatment outcomes related to psychoactive substance use among individuals with severe mental disorders remain a burden in patient care. Routine screening for substance use at the out-patient department should evaluate risk for adverse effects of these substances and not only substance dependence.