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.

中文翻译：

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南非豪登省急性精神病住院患者物质使用的流行率和临床相关性

背景 精神障碍和物质使用障碍 (SUD) 通常同时发生，影响医疗保健结果。当存在合并症时，物质使用的诊断通常是不充分的。了解精神病患者中物质使用的流行情况对于为南非的临床实践和服务发展提供信息至关重要。目的 确定急性精神科住院患者中 SUD 的患病率和临床相关性。环境 本研究的环境是海伦约瑟夫医院急性精神病病房。方法 进行了一项横断面研究，邀请连续入院的患者参加使用酒精使用障碍识别测试 (AUDIT) 和药物使用障碍识别测试 (DUDIT) 问卷的结构化临床访谈。在有和没有SUD的人之间进行了统计比较。结果 在 150 名参与者中，100 名 (67%) 被确定为 SUD。患有 SUD 的人更年轻 (p = 0.0010)，更常见的是男性 (p = 0.012)，获得残疾补助金的可能性较小 (p = 0.015)，并且更有可能被警察、救护车或自己带到医院而不是家人成员（p = 0.025）。几乎一半患有双相情感障碍（47.3%）和精神分裂症（41.4%）的人患有 SUD。23 名 (15%) 在问卷中被确定为 SUD 的参与者在临床上被遗漏。只有两名参与者在出院时被转介接受住院物质康复治疗。结论 物质使用障碍在精神科住院患者中非常普遍。AUDIT 和 DUDIT 是常规临床实践中潜在有用的筛查工具。