Little is known about important biopsychosocial differences between patients depending on the number of diagnosed comorbid psychiatric disorders, including the presence or absence of substance use disorder (SUD) comorbidity. This study investigated for differences in psychosocial disadvantage, psychiatric disorders, and health service utilization amongst 194 general hospital patients referred to consultation-liaison psychiatry (CLP) with either no psychiatric diagnosis, single psychiatric diagnosis, multiple (non-SUD) psychiatric diagnoses, or one or more psychiatric diagnoses plus SUD comorbidity. The results revealed that SUDs were the commonest diagnostic category (34%). The SUD comorbidity group had the highest rates of disadvantaged housing, were prescribed the most psychoactive medications, and 20% prematurely self-discharged against medical advice. Increased SUDs were associated with reduced length of stay, men, younger age, increased investigations, and reduced private health insurance subscription. Patients with SUD comorbidity versus multiple psychiatric diagnoses had reduced odds of adjustment disorder, somatic symptom disorder, and insomnia disorder. Post-traumatic stress disorder was the strongest predictor of multiple SUDs, followed by cluster B personality disorders. In conclusion, SUDs have become a leading clinical focus for CLP. The presence or absence of SUDs amongst patients with multiple disorders has important implications for engagement in treatment, patterns of comorbidity, and prescribing practices.

根据诊断出的共病精神疾病的数量，包括是否存在物质使用障碍 (SUD) 共病，对患者之间重要的生物心理社会差异知之甚少。本研究调查了 194 名转诊至咨询联络精神病学 (CLP) 的综合医院患者在心理社会不利、精神障碍和卫生服务利用方面的差异，这些患者要么没有精神病学诊断，要么有单一精神病学诊断，要么有多个（非 SUD）精神病学诊断，要么一项或多项精神科诊断加上 SUD 合并症。结果显示 SUD 是最常见的诊断类别 (34%)。SUD 合并症组的弱势住房率最高，开具的精神活性药物最多，20% 的人不顾医疗建议而过早地自行出院。SUD 的增加与住院时间缩短、男性、年龄较小、调查增加和私人医疗保险订阅减少有关。与多种精神疾病诊断相比，患有 SUD 合并症的患者出现适应障碍、躯体症状障碍和失眠障碍的几率降低。创伤后应激障碍是多种 SUD 的最强预测因子，其次是 B 类人格障碍。总之，SUD 已成为 CLP 的主要临床焦点。多种疾病患者中 SUD 的存在与否对治疗参与、合并症模式和处方实践具有重要意义。并减少私人医疗保险的认购。与多种精神疾病诊断相比，患有 SUD 合并症的患者出现适应障碍、躯体症状障碍和失眠障碍的几率降低。创伤后应激障碍是多种 SUD 的最强预测因子，其次是 B 类人格障碍。总之，SUD 已成为 CLP 的主要临床焦点。多种疾病患者中 SUD 的存在与否对治疗参与、合并症模式和处方实践具有重要意义。并减少私人医疗保险的认购。与多种精神疾病诊断相比，患有 SUD 合并症的患者出现适应障碍、躯体症状障碍和失眠障碍的几率降低。创伤后应激障碍是多种 SUD 的最强预测因子，其次是 B 类人格障碍。总之，SUD 已成为 CLP 的主要临床焦点。多种疾病患者中 SUD 的存在与否对治疗参与、合并症模式和处方实践具有重要意义。其次是B类人格障碍。总之，SUD 已成为 CLP 的主要临床焦点。多种疾病患者中 SUD 的存在与否对治疗参与、合并症模式和处方实践具有重要意义。其次是B类人格障碍。总之，SUD 已成为 CLP 的主要临床焦点。多种疾病患者中 SUD 的存在与否对治疗参与、合并症模式和处方实践具有重要意义。