Comorbid substance abuse and recovery from acute psychiatric relapse.
OBJECTIVE
The study investigated whether chronic mentally ill patients whose psychiatric relapse was complicated by active substance abuse recovered from relapse at a different rate than similar patients with no comorbid substance abuse.


METHODS
A total of 401 patients involuntarily hospitalized on a short-term psychiatric treatment unit received a urine toxicology screen on admission; the severity of their psychiatric symptoms was rated on the fifth day of hospitalization using the Brief Psychiatric Rating Scale (BPRS). Differences in scores between patients who had positive screens and those who had negative screens were evaluated for various diagnostic groups.


RESULTS
Patients who had a positive screen and a primary discharge diagnosis of psychoactive substance abuse had a BPRS total score indicating less psychopathology than similarly diagnosed patients with negative screens. Patients who had positive screens and a diagnosis of personality disorder had some BPRS subscale scores indicating greater psychopathology than their counterparts with negative screens. No other significant differences in recovery rates between the two groups were found, although comparisons indicated trends toward faster recovery in some areas of functioning by schizophrenic patients with positive screens and affective disorder patients with negative screens.


CONCLUSIONS
Results suggest that use of a urine toxicology screen and the BPRS early in treatment may aid in assessing the acute course of several psychiatric disorders and the effect of comorbidity.
Sanguineti
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Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107.
Samuel
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D000208:Acute Disease; D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D011619:Psychotropic Drugs; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
D013287:Illicit Drugs; D011619:Psychotropic Drugs