Trends in Psychiatric Hospitalizations of Patients With Dual Diagnosis in Spain

Sánchez-Lafuente, Carlos Gómez; Guzmán-Parra, José; Suárez, Juan; Bordallo-Aragón, Antonio; Fonseca, Fernando Rodríguez de; Mayoral-Cleries, Fermín

doi:10.1080/15504263.2022.2053770

Cited by 2 publications

(1 citation statement)

References 42 publications

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“…Unlike that reported in general psychiatry settings, the diagnosis of lifetime substance use disorders, that was identified in 70% of our sample, was not associated with shorter LoS. Without the legal constraints imposed by the incarceration, a significant proportion of patients with comorbid substance use disorders interrupt their stay due to craving and intolerance to the hospital rules [50,51].…”

Section: Discussioncontrasting

confidence: 74%

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

et al. 2023

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Criminological and sociodemographic variables, such as previous criminal convictions, increased risk of violence, early onset of mental disorder, antisocial personality, psychosis and low social support, have all been related to longer length of stay (LoS) and poorer outcome in long stay forensic services. The factors impacting on LoS and clinical response in acute care specialized units are poorly documented. To address this issue, we examined the psychiatric records of all cases admitted between January 1st and December 31th 2020 in the sole acute ward for detained persons located in the central prison of the Geneva County, Switzerland. Information on judicial status included pre-trial versus sentence execution, previous incarcerations, and age of the first incarceration. Sociodemographic data included age, gender, marital status, and education attainment. Previous inpatient stays prior to incarceration were recorded. All of the ICD-10 clinical diagnoses were made by two independent, board-certified psychiatrists blind to the scope of the study. The standardized assessment was based on the HoNOS (Health of Nation Outcome Scales) at admission and discharge, HONOS-secure at admission, HCR-20 (Historical Clinical Risk 20) version 2, PCL-R (Psychopathy Checklist Revised), and SAPROF (Structured Assessment of Protective Factors). Stepwise forward multiple linear regression models predicting the LoS and delta HONOS respectively were built with the above mentioned parameters. The selected variables were then used in univariate and multivariable regression models. Higher HCR-scores (mainly on clinical items), and longer LoS were related to higher delta HONOS scores. In contrast, cases in pre-trial detention showed a worst clinical outcome. In multivariable models, all three variables remained independent predictors of the clinical outcome and explained 30.7% of its variance. Only education and diagnosis of borderline personality were related to the LoS and explained 12.6% of its variance in multivariable models. Our results suggest that the use of acute wards specialized in forensic psychiatry are mainly useful for patients with prior inpatient care experience, and higher violence risk during sentence execution. In contrast, they seem to be less performant for persons in pre-trial detention that could benefit from less restrictive clinical settings.

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Section: Discussioncontrasting

confidence: 74%

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

et al. 2023

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Investigating the Critical Period for Alcohol or Other Drug-Related Presentations Following Access to Residential Substance Use Treatment: a Data Linkage Study

Tisdale,

Leung,

de Andrade

et al. 2024

Int J Ment Health Addiction

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Individuals who access residential treatment for substance use disorders are at a greater risk of negative health and substance-use outcomes upon exiting treatment. Using linked data, we aimed to identify predictive factors and the critical period for alcohol or other drug (AOD)-related events following discharge. Participants include 1056 individuals admitted to three residential treatment centres in Queensland, Australia from January 1 2014 to December 31 2016. We linked participants’ treatment data with administrative data from hospitals, emergency departments, AOD services, mental health services and the death registry up to December 31 2018. We used survival analysis to examine presentations for AOD-related events within two-years of index discharge. A high proportion of individuals (57%) presented to healthcare services for AOD-related events within 2 year of discharge from residential treatment, with the first 30 days representing a critical period of increased risk. Completing residential treatment (aHR = 0.49 [0.37–0.66], p < .001) and high drug-abstaining self-efficacy (aHR = 0.60 [0.44–0.82], p = .001) were associated with a reduced likelihood of AOD-related events. Individuals with over two previous residential treatment admissions (aHR = 1.31 [1.04–1.64], p = .029), identifying as Indigenous Australian (aHR = 1.34 [1.10–1.63], p < .001), alcohol as a primary substance (aHR = 1.58 [1.30–1.92], p < .001), and receiving a Disability Support Pension (aHR = 1.48 [1.06–2.06], p = 0.022) were at a greater likelihood. The high proportion of individuals that present to health and drug services for AOD-related events, especially in the first 30 days post-discharge, highlights the need for continued support following discharge from substance use treatment.

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Trends in Psychiatric Hospitalizations of Patients With Dual Diagnosis in Spain

Cited by 2 publications

References 42 publications

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

Investigating the Critical Period for Alcohol or Other Drug-Related Presentations Following Access to Residential Substance Use Treatment: a Data Linkage Study

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