Background Mental disorders and substance use disorders (SUD) commonly occur together, impacting healthcare outcomes. The diagnosis of substance use is often inadequate when comorbidity is present. It is vital to understand the prevalence of substance use amongst psychiatric patients to inform both clinical practice and service development in South Africa. Aim To ascertain the prevalence and clinical correlates of SUD amongst acute psychiatric inpatients. Setting The setting for this study was Helen Joseph Hospital acute psychiatric ward. Methods A cross-sectional study was conducted whereby consecutively admitted patients were invited to participate in a structured clinical interview utilising the alcohol use disorders identification test (AUDIT) and drug use disorders identification test (DUDIT) questionnaires. Statistical comparisons were made between those with and without SUD. Results Of 150 participants, 100 (67%) were identified with a SUD. Those with SUD were younger ( p = 0.0010), more often male ( p = 0.012), less likely to have a disability grant ( p = 0.015) and more likely to be brought to hospital by police, ambulance or self than by a family member ( p = 0.025). Almost half of people with bipolar disorder (47.3%) and schizophrenia (41.4%) had comorbid SUD. Twenty-three (15%) participants identified with SUD on questionnaire had been missed clinically. Only two participants were referred for inpatient substance rehabilitation on discharge. Conclusion Substance use disorders are highly prevalent amongst psychiatric inpatients. The AUDIT and DUDIT are potentially useful screening tools in routine clinical practice. Greater collaboration between psychiatric and substance rehabilitation services is recommended.

Background: Doctors are at high risk of burnout, which has far-reaching consequences on an individual and organisational level. Several studies have shown an association between burnout and depression.Aim: This study aimed to determine the rate of burnout and depressive symptoms among doctors, as well as factors associated with both conditions.Setting: Charlotte Maxeke Johannesburg Academic Hospital.Methods: Burnout was measured using the Maslach Burnout Inventory–Human Services Survey and defined as the total score of high emotional exhaustion (≥ 27 points) + high depersonalisation (≥ 13 points). Individual subscales were analysed separately. Depressive symptoms were screened using the Patient-Health Questionnaire-9 (PHQ-9) and a score of ≥ 8 was deemed indicative of depression.Results: Of the respondents (n = 327 for burnout and n = 335 for depression), 46.2% screened positive for burnout, whilst 53.73% screened positive for depression. Factors associated with increased burnout risk were younger age; Caucasian race; internship and/or registrarship; the discipline of emergency medicine; and having a prior psychiatric diagnosis of depressive and/or anxiety disorder. Factors associated with increased risk of depressive symptoms were females; younger age; being an intern, medical officer or registrar; disciplines of anaesthetics and obstetrics and gynaecology; having a prior psychiatric diagnosis of depressive and/or anxiety disorder; and family history of psychiatric disorder.Conclusion: A high rate of burnout and depressive symptoms was determined. Although there is an overlap between the two conditions in terms of both symptomatology and risk factors, specific risk factors were determined for each in this population.Contribution: This study highlighted the rate of burnout and depressive symptoms experienced by doctors at the state level hospital necessitating individual and institutional interventions to address this.