Prevalence of substance use disorder among psychiatric patients at Eradah Complex and Mental Health-Riyadh, Saudi Arabia

Studies in clinical populations with co-occurring mental health and substance use disorders consistently show that the latter have a negative impact on treatment and disease outcomes (1). The high prevalence of comorbidity between substance use disorders (SUD) and other mental illnesses does not necessarily mean that one causes the other. Proving causality or directionality is difficult for several reasons. For example, behavioral or emotional problems may be undiagnosed (subclinical symptoms), but subclinical mental health problems may trigger substance use (2,3).

We conducted a cross-sectional study to determine the prevalence of SUD and its association with sociodemographic characteristics of hospitalized patients at Eradah Complex and Mental Health-Riyadh. We used total population sampling technique, selecting all psychiatric patients admitted between January 2018 and October 2019.

A total of 380 participants were enrolled in this study. The prevalence of SUD among psychiatric inpatients was 236 (62%). In terms of sociodemographic characteristics, 43% were male, 22% were aged between 30 and 39 years, 62% were Saudis, 49% were single, 19% had secondary education, 37% were unemployed, and 31% were lived in Riyadh. For most psychiatric disorders, 36% were schizophrenia, 18% were bipolar affective disorder, and 7% were schizoaffective disorder.

SUD was significantly associated with age, gender, and marital status, but not with nationality, education, employment status, or place of residence. Associations between sociodemographic characteristics and SUD were found in the age groups 20-29 years, 30-39 years, and 40-49 years (OR = 4.43, 5.92, and 3.25, respectively), male (OR = 2.41), and single (OR = 4.96). In addition, associations were found between psychiatric disorders and SUD, including schizophrenia (OR = 17.4) and bipolar affective disorder (OR = 9.67).

Editorial notes: Research has shown that comorbid chronic physical and behavioral health conditions (mental and SUD) are associated with greater functional impairment and increased health care costs. As with comorbid mental health conditions, integrated care is critical to address physical health comorbidities (4). Therefore, the Department of Health is working hard to control substance use in Saudi Arabia. Many efforts are being made to prevent entry into substance use and to encourage individuals with SUD to seek proper treatment.

The study showed that the prevalence of SUD in psychiatric disorders is high; therefore, it is recommended that professionals pay attention to the importance of substance use in psychiatric patients. In addition, active screening and comprehensive prevention plans are recommended for all patients with psychiatric disorders, especially those with high risk factors.

This study was conducted at SUD psychiatric inpatients at Eradah Complex and Mental Health-Riyadh, and its results do not represent the characteristics of all SUD patients at Saudi Arabia, i.e., those seeking treatment and those not seeking treatment. However, it is very useful to consider which groups may be more strongly associated with SUD than others.

Keywords: substance use disorder, SUD, psychiatric disorder, Saudi Arabia

References

1. RachBeisel J, Scott J, Dixon L. Co-occurring severe mental illness and substance use disorders: a review of recent research. Psychiatr Serv. 1999;50(11):1427–1434.
2. Santucci K. Psychiatric disease and drug abuse. Curr Opin Pediatr. 2012;24(2):233-237.
3. Kelly TM, Daley DC. Integrated treatment of substance use and psychiatric disorders. Soc Work Public Health. 2013;28(0):388-406.
4. Hartz SM, Pato CN, Medeiros H, et al. Comorbidity of severe psychotic disorders with measures of substance use. JAMA Psychiatry. 2014;71(3):248-254.