Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census

Abstract

Background: Most studies on substance use among psychiatric patients focus on patients within specific diagnostic categories. Less is known about substance use among the general psychiatric patient population. The aim of this study was to investigate the clinical and demographic variation in the prevalence of substance use among psychiatric in-patients and outpatients in Norway.Methods: A national census in psychiatric institutions and outpatient clinics was conducted. Data were returned for 2,358 in-patients (response rate, 65%) and 23,167 outpatients (response rate, 60%). Substance use was measured based on substance use disorder diagnosis or reported substance use in the last four weeks (alcohol 2–4 days a week or illicit drug use). Regression analyses controlling for demographic and socio-demographic characteristics were carried out.Results: Substance use was identified in 32.4% of in-patients and 13.9% of outpatients. The most frequently reported substances used were alcohol, sedatives and cannabis. Among in-patients, the prevalence of substance use was highest in patients with schizophrenia, personality disorders and anxiety disorders. Among outpatients, the prevalence was highest in patients with schizophrenia and other psychoses. In-patients with anxiety disorders and outpatients with schizophrenia and other psychoses had a significantly higher risk of substance use than other patients. In both samples, the prevalence of substance use was higher among males, 24–29-year-olds and the most socially deprived.Conclusions: This study provides further knowledge about patients at risk for co-morbid substance abuse and poor treatment outcomes. Clinicians may consider targeting patients with severe mental illness, young males and those who are socially deprived in efforts to prevent emerging substance abuse and improve outcomes.

Prevalence of substance use and associated factors among patients with mental illness at Muhimbili National Hospital, Dar es Salaam, Tanzania

“…The current study reported that males have 2 times higher odds of substance use than females. Similar findings have been previously reported in the same country (Mwanza region), the US, Norway, Denmark, and Nigeria [9, 17, 18, 41, 42] showing that being a male is a significant predictor of substance use among patients with mental illness. This is explained by the possibility that sex significantly influences a particular type of mental disorder an individual develops, the differences in socio-economic determinants of mental health, social status, susceptibility, and exposure to life stressors and coping skills.…”

“…This shows a need for special attention to this particular risk group to identify substance use early and treat it appropriately. However, our findings are similar to a study conducted in Norway [28]. Screening for substance use and treatment of both mental illness and substance use problems improve medication adherence and reduction relapses as a consequence of substance use among this population.…”

“…It's not easy to know if cannabis and other illegal drugs exist unless someone is in the loop of business which is done in secrecy [31]. These findings were relatively similar to those reported in a cross-sectional study in lake zone Tanzania whereby [18] and other countries such as Sweden [36], Norway [17,32,33], and Nigeria [7]. Similarities in the type of substance (s) commonly used among patients with mental illness between the current study and other studies can be explained by the availability of the particular substances in those countries and the patient's characteristics.…”

“…In addition, acute or chronic use of substances mimics mental illness symptoms making it difficult to distinguish between symptoms due to substance use disorder or withdrawal from substance use and mental illness symptoms [17]. However, screening tools vary across countries.…”

Polysubstance use in young people accessing residential and day‐treatment services for substance use: substance use profiles, psychiatric comorbidity and treatment completion

“…Comorbid presentations in treatment are diverse, and most commonly include mood [18,19], anxiety [20,21], eating [22] and post-traumatic stress disorders (PTSDs) [23,24]. There is also a high prevalence of positive psychotic symptoms and schizophrenia [25,26]. The relationship between mental health and SUDs is bidirectional [27][28][29][30], and different mental health symptoms may be associated with using different clusters of substances to achieve the desired effects (e.g.…”