Patterns of Substance Use Disorders and Associated Co-occurring Psychiatric Morbidity among Patients Seen at the Psychiatric Unit of a Tertiary Health Center

Background: Understanding the pattern of co-occurring mental illness in patients with substance use disorders (SUDs) is essential in improving the prevention and treatment of substance use-related problems. This study examined the pattern of SUDs, the associated co-occurring psychiatric morbidities, and associated factors among patients with SUDs managed at a tertiary health center.Methods: The records of patients who presented with SUDs between ۲۰۱۰ and ۲۰۱۹ were examined. Socio-demographics of interest were extracted from case files. Substance use diagnoses, as well as associated co-occurring mental illness, were extracted and entered into SPSS software. Bivariate analyses including the risk of developing co-occurring mental disorder were calculated.Findings: For most patients, the initiation of substance use was before the age of ۲۱ years, while the onset of SUDs was between ۲۱-۳۰ years. Cannabis use disorders (CUDs), alcohol use disorders (AUDs), and nicotine use disorders (NUDs) were the commonest SUDs. Compared with those with CUDs, non-users of cannabis were significantly less likely to develop co-occurring mental illness [odds ratio (OR) = ۰.۲۵, ۹۵% confidence interval (CI) =۰.۱۳-۰.۴۲, P = ۰.۰۰۱]. Those with tramadol use disorders (OR = ۲.۱۳, ۹۵% CI = ۱.۰۳-۴.۴۱, P = ۰.۰۴۰) and those without pentazocine use disorders (P = ۰.۰۰۳) were more likely to have a comorbid mental illness. Patients with AUDs (P = ۰.۰۰۱), CUDs (P = ۰.۰۰۱), NUDs (P = ۰.۰۰۱), and tramadol use disorders (P = ۰.۰۴۵) were significantly more likely to be multiple substance users.Conclusion: Results suggest an association between SUDs and co-occurring mental illness, though differences in these associations were noticed across the categories of substances. This emphasizes a holistic approach to prevention and care of patients presenting with SUDs.

Keywords:

Dual diagnosis , mental disorders , Substance-related disorders , Substance dependence