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Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

Royal Free and University College London Medical School, Department of Psychiatry & Behavioural Sciences, Wolfson Building, 48 Riding House Street, London W1N 8AA. p.phillips{at}ucl.ac.uk

SONIA JOHNSON, MSc MRCPsych, Senior Lecturer in Social & Community Psychiatry

Royal Free and University College London Medical School, Department of Psychiatry & Behavioural Sciences, Wolfson Building, 48 Riding House Street, London W1N 8AA. p.phillips{at}ucl.ac.uk

Declaration of interest

This study was funded through a research fellowship awarded to the principal author by the Camden & Islington Mental Health & Social Care NHS Trust. There are no competing interests.

AIMS AND METHOD

Ward staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients.

RESULTS

264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with ‘dual diagnosis’ was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission.

CLINICAL IMPLICATIONS

It appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.

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