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Substance misuse in the psychiatric emergency service; a descriptive study.

Chaput Y, Lebel MJ, Beaulieu L, Paradis M, Labonté E - Subst Abuse (2014)

Bottom Line: Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools.Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM.The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.

View Article: PubMed Central - PubMed

Affiliation: Presently in Private Practice (during this study, Department of Psychiatry, McGill University, Montreal, Quebec, Canada).

ABSTRACT
Substance misuse is frequently encountered in the psychiatric emergency service (PES) and may take many forms, ranging from formal DSM-IV diagnoses to less obvious entities such as hazardous consumption. Detecting such patients using traditional screening instruments has proved problematic. We therefore undertook this study to more fully characterize substance misuse in the PES and to determine whether certain variables might help better screen these patients. We used a prospectively acquired database of over 18,000 visits made to four PESs during a 2-year period in the province of Quebec, Canada. One of the variables acquired was a subjective rating by the nursing staff as to whether substance misuse was a contributing factor to the visit (graded as direct, indirect, or not at all). Substance misuse accounted for 21% of all diagnoses and alcohol was the most frequent substance used. Patients were divided into those with primary (PSM), comorbid (CSM) or no substance misuse (NSM). Depressive disorders were the most frequent primary diagnoses in CSM, whereas personality and substance misuse disorders were frequent secondary diagnoses in PSM. Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools. Those situations that did have sufficient details included those with a previous history of substance misuse, substance misuse within 48 hours of the visit, and visits graded by the nursing staff as being directly and/or indirectly related to substance misuse. Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM. The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.

No MeSH data available.


Related in: MedlinePlus

The age distribution of visits tagged as being without, with primary or with comorbid substance misuse.
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Related In: Results  -  Collection


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f4-sart-8-2014-007: The age distribution of visits tagged as being without, with primary or with comorbid substance misuse.

Mentions: Male gender predominated in both the PSM and CSM groups (65% and 62%, respectively, versus 47% in the NSM group). As illustrated in Table 1, PSM or CSM tagged visits were significantly more likely to be made by men, when compared to NSM tagged visits. No gender difference was found between PSM and CSM groups. Age was examined next and divided into 3 subcategories (18 to 39, 40 to 59, and 60 years of age and above). Both the PSM and CSM groups comprised a significantly younger cohort in comparison to the NSM group. However, this attained clinical significance (RRR ≥ 1.5 or ≤ 0.667) for the CSM group only (Table 1). The age profile for the NSM, PSM, and CSM groups (raw untransformed data for the total sample population) is shown in Figure 4.


Substance misuse in the psychiatric emergency service; a descriptive study.

Chaput Y, Lebel MJ, Beaulieu L, Paradis M, Labonté E - Subst Abuse (2014)

The age distribution of visits tagged as being without, with primary or with comorbid substance misuse.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3928057&req=5

f4-sart-8-2014-007: The age distribution of visits tagged as being without, with primary or with comorbid substance misuse.
Mentions: Male gender predominated in both the PSM and CSM groups (65% and 62%, respectively, versus 47% in the NSM group). As illustrated in Table 1, PSM or CSM tagged visits were significantly more likely to be made by men, when compared to NSM tagged visits. No gender difference was found between PSM and CSM groups. Age was examined next and divided into 3 subcategories (18 to 39, 40 to 59, and 60 years of age and above). Both the PSM and CSM groups comprised a significantly younger cohort in comparison to the NSM group. However, this attained clinical significance (RRR ≥ 1.5 or ≤ 0.667) for the CSM group only (Table 1). The age profile for the NSM, PSM, and CSM groups (raw untransformed data for the total sample population) is shown in Figure 4.

Bottom Line: Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools.Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM.The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.

View Article: PubMed Central - PubMed

Affiliation: Presently in Private Practice (during this study, Department of Psychiatry, McGill University, Montreal, Quebec, Canada).

ABSTRACT
Substance misuse is frequently encountered in the psychiatric emergency service (PES) and may take many forms, ranging from formal DSM-IV diagnoses to less obvious entities such as hazardous consumption. Detecting such patients using traditional screening instruments has proved problematic. We therefore undertook this study to more fully characterize substance misuse in the PES and to determine whether certain variables might help better screen these patients. We used a prospectively acquired database of over 18,000 visits made to four PESs during a 2-year period in the province of Quebec, Canada. One of the variables acquired was a subjective rating by the nursing staff as to whether substance misuse was a contributing factor to the visit (graded as direct, indirect, or not at all). Substance misuse accounted for 21% of all diagnoses and alcohol was the most frequent substance used. Patients were divided into those with primary (PSM), comorbid (CSM) or no substance misuse (NSM). Depressive disorders were the most frequent primary diagnoses in CSM, whereas personality and substance misuse disorders were frequent secondary diagnoses in PSM. Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools. Those situations that did have sufficient details included those with a previous history of substance misuse, substance misuse within 48 hours of the visit, and visits graded by the nursing staff as being directly and/or indirectly related to substance misuse. Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM. The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.

No MeSH data available.


Related in: MedlinePlus