Background Comorbid psychiatric and substance use disorders are common and present several treatment challenges. Aim The aim of this study was to determine which patient and substance factors are associated with the completion of a substance rehabilitation programme in psychiatric inpatients. Setting The study was conducted at the Substance Rehabilitation Unit (SRU) at Weskoppies Hospital, a psychiatric training hospital in South Africa, which offers a 6-week programme at the hospital for psychiatric inpatients. Methods This descriptive, retrospective hospital-based study was carried out comparing completers and non-completers of the SRU programme with respect to patient and substance factors. All patients accepted into the SRU during 2013–2014 were included (n = 119). Data were collected over a year (2016–2017) from the clinical files, SRU referral forms, SRU attendance register, hospital computerised demographic records, nursing notes and administration files using a data collection sheet designed by the researchers for this study. Comparison between completers and non-completers was performed using Chi-Square or Fisher’s Exact tests. Results The SRU accepted 119 patients from January 2013 to December 2014. The majority of the sample were involuntary patients (n = 39), 30–49 years old (n = 57), male (n = 89), unmarried (n = 112), never having received a disability grant (n = 27), unemployed (n = 96) and with a Grade 8–11 education (n = 49). Substance-induced psychotic disorders (n = 39), schizophrenia (n = 29) and bipolar disorders (n = 22) were found to be common. Frequent medical comorbidities included head injury (n = 27), cardiovascular disease (n = 18) and HIV reactivity (n = 7). Cannabis (n = 98), alcohol (n = 94) and nicotine (n = 90) were the most frequently used substances. Level of education (p = 0.004), disability grant status (p = 0.004), Nyaope use (p = 0.001) and nicotine use (p = 0.049) were statistically seen to be significantly associated with completion. Psychiatric diagnoses and general medical comorbidity were not associated with completion. Conclusions This study has yielded several results in areas that have not yet been well researched in South Africa. Risk factors for non-completion may include lower levels of education, being on a disability grant and using Nyaope or nicotine, but may vary in different settings. Future research should focus on identifying further factors that may affect completion of substance rehabilitation in psychiatric inpatients, the role of disability grants in patients with co-occurring disorders and the effect of Nyaope and nicotine use on treatment outcomes in this population. Effective and accessible interventions to assist vulnerable patients also need to be identified.

中文翻译：

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与在精神病培训医院成功完成物质康复计划相关的因素

背景 共病的精神和物质使用障碍很常见，并提出了一些治疗挑战。目的 本研究的目的是确定哪些患者和物质因素与精神科住院患者完成物质康复计划有关。设置 该研究在南非的精神病培训医院 Weskoppies 医院的物质康复部门 (SRU) 进行，该医院为精神病住院患者提供为期 6 周的项目。方法 这项描述性、回顾性的医院研究比较了 SRU 计划的完成者和未完成者的患者和物质因素。包括 2013-2014 年接受 SRU 的所有患者（n = 119）。从临床档案中收集了一年（2016-2017）的数据，SRU 转诊表、SRU 出勤登记表、医院计算机化人口统计记录、护理记录和管理文件，使用研究人员为本研究设计的数据收集表。完成者和非完成者之间的比较使用卡方或费舍尔精确检验进行。结果 SRU 于 2013 年 1 月至 2014 年 12 月期间接收了 119 名患者。大多数样本为非自愿患者（n = 39）、30-49 岁（n = 57）、男性（n = 89）、未婚（n = 112） )、从未领取过残疾补助金 (n = 27)、失业 (n = 96) 并接受过 8-11 年级教育 (n = 49)。发现物质引起的精神病（n = 39）、精神分裂症（n = 29）和双相情感障碍（n = 22）很常见。常见的合并症包括头部受伤（n = 27），心血管疾病（n = 18）和 HIV 反应性（n = 7）。大麻（n = 98）、酒精（n = 94）和尼古丁（n = 90）是最常用的物质。教育水平 (p = 0.004)、残疾补助状况 (p = 0.004)、Nyaope 使用 (p = 0.001) 和尼古丁使用 (p = 0.049) 在统计学上被认为与完成显着相关。精神病学诊断和一般医学合并症与完成无关。结论 这项研究在南非尚未得到充分研究的领域取得了多项成果。未完成的风险因素可能包括教育水平较低、领取残疾补助金以及使用 Nyaope 或尼古丁，但在不同的环境中可能会有所不同。未来的研究应侧重于确定可能影响精神科住院患者物质康复完成的进一步因素、残疾补助金在同时发生的疾病患者中的作用以及 Nyaope 和尼古丁使用对这一人群治疗结果的影响。还需要确定帮助弱势患者的有效和可及的干预措施。