title: Sex differences in first-admission psychiatric inpatients with and without a comorbid substance use disorder.
abstract: OBJECTIVE
  We assessed sex differences in a sample of first-admission psychiatric inpatients with and without comorbid substance use disorder (SUD) to identify possible risk factors and targets for sex-tailored treatment interventions.
  
  
  METHODS
  A retrospective study of first admissions to the University Psychiatry Ward, "Maggiore della Carità" Hospital, Novara, Italy, between 2003 and 2012 was accomplished. The clinical charts of patients with (N = 362) and without comorbid SUD (N = 1111) were reviewed.
  
  
  RESULTS
  Differences in employment, educational, and marital statuses were found between male and female psychiatric patients with and without comorbid SUD. Having a degree was a protective factor for males, whereas it was a risk factor for females. Being divorced and having family problems were both risk factors for comorbidity in females. Regarding the diagnosis, results overlapped in males and females, and both affective and other disorders were risk factors for a comorbid SUD.
  
  
  CONCLUSIONS
  A significant difference between male and female psychiatric patients with a comorbid SUD was the males' overall poorer psychosocial functioning. Marital status and family problems were risk factors for comorbid SUD in females. Both males and females showed various pathways of access to and choices of substances and, eventually, experienced different impacts on their lives. Hospitalization might help to set up a targeted intervention for patients with comorbidity, while accounting for sex differences. With respect to males, a treatment approach focused on the substance alone might help improve their functioning; females might have a greater benefit from a treatment approach focused on distress, family problems, and relational issues.
authors: From the Department of Translational Medicine (CG, AL, AF, MP, ET, PZ), Institute of Psychiatry, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and Department of Public Health (FB, RS, MRG), University of Turin, Turin, Italy.
authors: Carla
authors: C
authors: Gramaglia
authors: Fabrizio
authors: F
authors: Bert
authors: Ada
authors: A
authors: Lombardi
authors: Alessandro
authors: A
authors: Feggi
authors: Marica
authors: M
authors: Porro
authors: Roberta
authors: R
authors: Siliquini
authors: Maria Rosaria
authors: MR
authors: Gualano
authors: Eugenio
authors: E
authors: Torre
authors: Patrizia
authors: P
authors: Zeppegno
mesh_terms: D000328:Adult; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology