Diagnosis and management of substance use disorders among inpatients with schizophrenia.
OBJECTIVE
The study examined the extent of clinical recognition of comorbid substance use disorders and the clinical management of these disorders among inpatients hospitalized for an acute exacerbation of schizophrenia.


METHODS
Medical records of 42 inpatients who met research diagnostic criteria for both schizophrenia and a current substance use disorder were reviewed for information about admission evaluation, inpatient management, discharge diagnosis, and disposition.


RESULTS
Alcohol use disorders were the most frequent co-occurring substance-related diagnoses, found for 86 percent of the dually diagnosed inpatients. Twenty-four patients (57 percent) did not receive a diagnosis of a substance-related disorder at admission, and 19 (45 percent) did not receive a substance-related diagnosis at discharge. Referral to inpatient or outpatient substance abuse treatment was documented for a minority of subjects.


CONCLUSIONS
The results suggest that improvements are needed in the process of clinical care for inpatients with schizophrenia who have co-occurring substance-related disorders. They highlight a need for education of health care providers and continuous quality improvement in this area.
Kirchner
J E
JE
University of Arkansas for Medical Sciences, Little Rock, USA.
Owen
R R
RR
Nordquist
C
C
Fischer
E P
EP
D000328:Adult; D000437:Alcoholism / Q000188:drug therapy; D001131:Arkansas; D017831:Diagnosis, Dual (Psychiatry); D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008485:Medical Audit; D011567:Psychiatric Department, Hospital / Q000592:standards*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications*; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*