Psychiatric Referrals Associated with Substance Use Disorders: Prevalence and Gender Differences

Abstract

A psychoactive substance use disorder (ICD-10) was diagnosed in 28% of 1222 psychiatric referrals in six general hospitals in Finland. In the age group 35 o 50 years, 53% of men and 29% of women had a substance use disorder. In the age group 35 to 50 years, sociodemographic characteristics differentiated men diagnosed with substance use disorders from other male consultation patients, but women with substance use disorders were similar to other female consultation patients. Urgency (i.e., consultation required within the same day) was accentuated in referrals associated with substance use disorders. Of attempted suicides, 65% were related to substance use disorders. Use of sedatives or hypnotics had more frequently induced disorders in women with substance use diagnosis compared to men with diagnosis (30% vs. 13%; p < 0.01). Female consultation patients with substance use disorders more often than respective male patients were current mental health outpatients. In conclusion, the proportion of substance use disorders among psychiatric consultation patients was remarkably higher in the present study (28%) compared with the average provided by the earlier literature (12%), and therefore, at least in Finland, psychiatric assessment of general hospital patients should always include assessment for the presence of substance use disorders. If substance use is only looked for in patients who have social problems typical of advanced misuse, detecting female substance use might be impeded. Relation of attempted suicides to substance use disorders was confirmed. To prevent misuse of prescribed drugs detected particularly in female consultation patients, and to prevent attempted suicides, doctors' attention is called to prescriptions of sedatives and hypnotics.

A multicenter investigation of consultation-liaison psychiatry in Italy

“…For example, a primary diagnosis of mental and behavioral disorders due to the use of psychoactive substances (F10-19) was infrequent (7%) in this population compared with the 30% prevalence rate found by some authors [27,28], although it is comparable with the results obtained by others (e.g., 5.4%) [29]. This may be due to the fact that specific psychiatric services for individuals with these disorders were set up after the psychiatric reform in Italy and therefore such patients are usually referred to these services rather than to C-L.…”

Comparação entre solicitações psiquiátricas de dois hospitais gerais universitários brasileiros: uso do protocolo de registro de interconsulta em saúde mental

“…Igualmente, nenhum dos estudos nacionais procurou comparar diferentes serviços de interconsulta. Isto seria particularmente importante, com a utilização de instrumento padronizado, na realização de futuros estudos multicêntricos na área, como os desenvolvidos pelo European Consultation-Liaison Workgroup for General Hospital Psychiatry and Psychosomatics (ECLW) 11,12,13,14,15,16 .…”

Caracterização do padrão de solicitações psiquiátricas em um hospital geral: estabilidade e mudanças em um período de 30 anos de um serviço de Interconsulta

“…1416 (66,9) 828 (30,0) 1465 (69,2) 642 (23,2) 2062 ( 1981-1985 1986-1990 1991-1995 1996-2000 2001-2005 2006- 1981-1985 1986-1990 1991-1995 1996-2000 2001-2005 2006- 1981-1985 1986-1990 1991-1995 1996-2000 2001-2005 2006- (10,8) 47 (13,5) 58 (14,3) 44 (10,8) 91 (13,2) 104 (14,1) 376 (13,0) Negra 19 (6,4) 41 (11,8) 26 (6,4) 32 (7,8) 50 (7,2) 63 (8,5) 231 (8,0) 1981-1985 1986-1990 1991-1995 1996-2000 2001-2005 2006- (10,2) 25 9,320 (7,5) 30 (9,6) 43 (10,2) 40 (9,9) 180 (9,5) Negra 19 (8,8) 31 (11,…”

“…Casada 105 (43,0) 154 (46,1) 199 (50,6) 194 (47,5) 354 50,7) 347 (46,6) 1353 (47,9Solteira 79 (32,4) 122 (36,5) 118 (30,0) 114 (27,9) 186 (26,6) 191 (25,6) 810 28,7Separada 31 12,724 7,231 (7,9) 45 (11,0) 94 (13,5) 123 (16,5) 348 12,3Viúva 29 (11,9) 34 (10,2) 45 (11,5) 55 (13,5) 64 (9,2) 84 (11,3) 311 (11,0) TOTAL ( Cônjuge e filhos 6 (9,8) 11 (10,8) 22 (24,4) 78 (32,2) 131 (27,3) 182 (32,0) 430…”

“…Afastado 60 (32,1) 71 (27,2) 60 (23,2) (9,6) 36 (13,8) 54 (20,8) 42 (13,5) 36 (8,5) 37 (9,1) (12,1) Aposentado 10 (5,3) 24 (9,2) 23 (8,9) 31 (9,9) 79 (18,6) 46 (11,4) (11,5) Desempregado 14 (7,5) 16 (6,1) 7 2,717 (5,4) 28 (6,6) 49 (12,1) 131 (7,1) Estudante 13 (7,0) 15 5,79 (3,5) 12 (3,8) 33 (7,8) 48 (11,9) 130 (7,0) Cuidando do ...…”