substance abuse comorbidity in hospitalized psychiatric patients population – 470 consequently...
DESCRIPTION
Age- Kfar Saul vs. Tel Ha Shomer Kfar SaulTel Ha Shomer Statistic analysis df= years old 51 (20.4 %) 66 (30 %)p= years old 143 (57.2%)81(36.8 %)p= and more years old 56 (22.4%)73 (33.2%)P=0.01TRANSCRIPT
Substance abuse comorbidity in hospitalized psychiatric patients
Population – 470 consequently admitted hospitalized patients
Kfar Shaul – 250 patientsTel Ha-Shomer – 220 patients
Substance abuse comorbidity in hospitalized psychiatric patients
Age – 18-70 years oldUp to 24 years old – 87 patients (18.5%)25 – 44 years old – 224 patients (47.7%)45 and more years old – 159 patients (33.8%)
Age- Kfar Saul vs. Tel Ha ShomerKfar Saul Tel Ha
ShomerStatisticanalysisdf=1
18-24 years old
51 (20.4 %) 66 (30 %) p=0.05
25-44 years old
143 (57.2%) 81(36.8 %) p=0.000
45 and more years old
56 (22.4%) 73 (33.2%) P=0.01
SexFemale – 165
patients (35% )
Male – 305 patients (65 %)
Place of birthIsrael – 308 patients
(65,5%)West-Europe ,America,
Australia, South Africa -112 patients (23.8%)
East-Asia, Africa, Middle East – 46 patients (9.8%)
Other – 2 patients (0.4%)
Substance abuse comorbidity in hospitalized psychiatric patients
Origin-Kfar Shaul vs. Tel ha Shomer
Kfar-Shaul Tel-Ha-Shomer
Statistic analysisdf=1
Israel 174 (69.6%)
134(60.9%)
p=0.05
West 59 (24.6%) 57 (25.9%) NS
East 17 (6.8%) 29 (13.2) p=0.03
Substance abuse comorbidity in hospitalized psychiatric patients
Working status
Frequency PercentWorkingStudents (incl. eshiva)UnemployedSocial security (mental problems)Social security (other problems)Other
107 20
40
178
5669
22.84.3
8.5
37.9
11.914.7
Substance abuse comorbidity in hospitalized psychiatric patients
Working status-Kfar Saul vs.Tel-Ha-ShomerKfar Shaul Tel-Ha-
ShomerStatistical Analysis df=1
WorkingStudents (incl. eshiva)UnemployedSocial security (mental problems)Social security (other problems)Other
34 (13.6%)16 (6.4%)
27 (10.8%)116 ( 46.4%)
20 (8.0%)
37 (14.8%)
73 (33.2%)4 (1.8%)
13 (5.9%)62 (28.1%)
36 (16.3%)
32 (14.5%)
p=000p=0.02
p=0.01p=0.000
p=0.006
NS
Substance abuse comorbidity in hospitalized psychiatric patients
Marital status
Frequency Percent
married 151 32.1
single 225 47.9
divorced 85 18.1
widow 5 1.1
other 4 0.9
Substance abuse comorbidity in hospitalized psychiatric patients Marital status - Kfar Shaul vs. Tel-Ha-Shomer
Kfar Shaul Tel-Ha-Shomer
Statistical Analysis df=1
married 63 (25.2%) 88 (40%) p=0.001
single 135 (54%) 90 (40.9%) p=0.005
divorced 47 (18.8%) 38 (17.2%) NS
widow 2 (0.8%) 0 NS
other 2 (0.8%) 2 (0.9%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Past psychiatric historyyes – 391 patients (83.2 %)no – 71 patients (15.5 %)
unclear – 6 (1.3%)
Substance abuse comorbidity in hospitalized psychiatric patients
Diagnosis
Frequency PercentOrganic disorders (incl. mental disorders due to drug abuse)
33 7.1%
Schizophrenia, schizophrenoform and schizoaffective d-r
237 50.4%
Affective disorders 126 26.8%Anxiety disorders 48 10.8%Personality disorders 26 5.4%
Substance abuse comorbidity in hospitalized psychiatric patients
Diagnosis Kfar Shaul vs. Tel-Ha-ShomerKfar Shaul Tel-Ha-
ShomerOrganic disorders (incl. mental disorders due to drug abuse)
28 (11.2%) 5 (2.2%) p=0.000
Schizophrenia, schizophrenoform and schizoaffective d-r
142 (56.8%) 95 ( 43.2%) p=0.004
Affective disorders 52 (20.8%) 74 (33.6%) p=0.002
Anxiety disorders 14 (5.6%) 34 (15.4%) p=0.001
Personality disorders 14 (5.6%) 12 (5.6%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Life time prevalence of drug abuse Positive (self report) – 113 patients 24.0%Cannabis – 93 patients (19.7%)Opioid – 27 patients (5.7%)Cocaine – 13 patients (2.7%)Amphetamine – 16 patients (3.4%)Methamphetamine – 31 patients (6.6%)
Substance abuse comorbidity in hospitalized psychiatric patients
Life time prevalence - frequency of abuse
2 - 10 cases per month – 42 patientsmore than 10 cases – 77 patientsunclear – 27 patients
Non-active substance abusers Kfar-Shaul vs. Tel-Ha-Shomer
Tel-Ha-Shomer
Kfar-Shaul Total Statistical Analysis df=1
20 (9.1%) 15 (6%) 35 (7.4%) NS
Substance abuse comorbidity in hospitalized psychiatric patients Non-active abusers diagnosis (N = 35)
Frequency Percent
Organic d-rs (incl. due to substance abuse)
3 8.6
Schizophrenia, schizophrenoform d-r and schizoaffective
22 62.9
Affective d-rs 6 17.1
Anxiety d-rs 1 2.9
Personality d-rs 3 8.6
Substance abuse comorbidity in hospitalized psychiatric patients
Frequency of abuse
Cannabis Amphetamine
Methamphetamine
Opioid Cocaine
2-10 cases/month
16 4 10 4 5
10 and more
35 0 6 12 0
unclear 6 1 2 6 3
Frequency of abuse of different drugs: Kfar-Shaul vs. Tel-Ha-Shomer
Drug Num of abusers
% of Total num of patients
Kfar-Shaul
% Kfar-Shaul
Tel-Ha-Shomer
% Tel-Ha-Shomer
Statistical Analysis df=1
Amphetamine
5 1.1 4 1.6 1 0.5 NS
Cocaine 7 1.5 4 1.6 3 1.4 NS
Methamphetamine
18 3.8 13 5.2 5 2.3 NS
Opiates 23 4.9 19 7.6 4 1.8 0.004
Cannabis 54 11.1 39 15.6 15 6.8 0.003
Substance abuse comorbidity in hospitalized psychiatric patients
Active abuse of the drugs (last month) 18 patients - positive for urine tests, but
negative in self reports34 patients - positive for urine tests and self
report24 patients - positive for self report, but
negative for urine testsTotal – 78 patients
Substance abuse comorbidity in hospitalized psychiatric patients
Urine testsTHC (Cannabis) - 30 positiveMethamphetamine - 7 positiveAmphetamine - 3 positiveCocaine - 5 positiveOpioid - 17 positive
Total – 52 positive
Substance abuse comorbidity in hospitalized psychiatric patients
Abusers vs. nonusers – age
AbusersN=78
NonusersN=392
Statistical Analysis df=1
Up to 24 years 24 (30.8%) 63 (16.1%) p<0.001
25-44 years 41 (52.6%) 183 (46.7%)
NS
45-64 years 12 (15.4%) 117 (29.8%)
p<0.001
65-70 years 1 (1,2 %) 29 (7.4%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Abusers vs. nonusers-sex
Abusersn=78
Nonusersn= 392
Male 60 (76.9%) 245 (62.5%)
Female 18 (23.1%) 147 (37.5%)
p<0.05
Substance abuse comorbidity in hospitalized psychiatric patients
Abusers vs. nonusers-marital status
Abusers n=78
NonusersN=392
Statistical Analysis df=1
Married 10 (12.8%) 141 (36%) p<0.001
Single 52 (66.7%) 173 (44.1%) p<0.001
Divorced 16 (20.5%) 69 (17.6%) NS
Widow 0 5 (1.3%) NS
Other 0 4 (1%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Abusers vs. nonusers-country of origin
Abusers N=78
Nonusers N=392
Statistical Analysis df=1
Israel 52 (66.7%) 256 (65.6%)
NS
Asia, Middle East, North Africa
2 (4.3%) 44 (11.3%)
p<0.05
Europe, South Africa, America, Australia
24 (30.8%) 88 (22.6%)
p< 0.05
Other 0 2 (0,5%) NS
Substance abuse comorbidity in hospitalized psychiatric patients Abusers vs. nonusers-working status
Abusersn=78
Nonusersn=392
Statistical Analysis df=1
Working 16 (20.5%) 91 (23.2%) NSStudents (inc. eshiva) 7 (9%) 13 (3.3%) NS
Unemployed 9 (11.5%) 31 (7.9%) NS
Soc. security due to mental problems
25 (32%) 153 (39.1%) NS
Soc. security due to other problems
8 (10.3%) 48 (12.2%) NS
Other 13 (16.7%) 56 (14.3%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Abusers vs. nonusers-diagnosis
Abusers (n=78) Nonusers (n=392)
Organic d-rs (incl. due to substance abuse)
19 (24.4%) 14 (3.7%)
Schizophrenia, schizophrenoform d-r and schizoaffective
37 (47.4%) 200 (51%)
Affective d-rs 14 (17.9%) 112 (28.5%)
Anxiety d-rs 2 (2.6%) 46 (11.7%)
Personality d-rs 6 (7.7%) 20 (5.1%)
Substance abuse comorbidity in hospitalized psychiatric patients
Abusers vs. nonusers-diagnosis (without organic d-rs) Abusers n=59
Nonusers n=378
Statistical Analysis df=1
Schizophrenia, schiphrenoform schizoaffective d-rs
37 (62.7%) 200 (52.9%) p=0.06
Affective d-rs 14 (23.7%) 112 (29.6%) NS
Anxiety d-rs 2 (3.4%) 46 (12.1%) NS
Personality d-rs 6 (10.2%) 20 (5.3%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Duration of drug abuse vs. duration of mental disorder Tel-Ha-Shomer
Kfar-Shaul
Total Statistical Analysis df=2
Duration of drug abuse is longer than that of mental problems
27 (56.3%) 10 (24.4%) 37 (41.6%) p = 0.004
Duration of drug abuse is similar to that of mental problems
11 (22.9%) 22 (53.7%) 33 (37.1%) p = 0.004
Duration of mental problems is longer than that of drug abuse
10 (20.8%) 9 (22.0%) 19 (21.3%) NS
Substance abuse comorbidity in hospitalized psychiatric patients Cannabis abuser vs. nonusers-diagnosis
Abusers n=54
Nonusers n=392
Organic (incl. due to substance abuse)
14 (25.9%) 14 (3.7%)
Schizophrenia, schizoaffective,schizophrenoform
27 (50%) 200 (51%)
Affective d-rs 9 (16.7%) 112 (28.5%)
Anxiety d-rs 0 46 (11.7%)
Personality d-rs 4 (7.4%) 20 (4.5%)
Substance abuse comorbidity in hospitalized psychiatric patients
Cannabis abusers vs. nonusers - diagnosis (without organic)
Abusers n=40
NonusersN=378
Statistical Analysis df=1
Schizophrenia,schizoaffective, schizophrenoform
27 (67.5%) 200 (52.9%) p=0.014
Affective d-rs 9 (22.5%) 112 (29.6%) NS
Anxiety d-rs 0 46 (12.2%) NS
Personality d-rs 4 (10%) 20 ( 5.3 %) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Psycho stimulants (amphetamine, methamphetamine, cocaine) - diagnosis
Amphetamine
Methamphetamine
Cocaine Total
Organic(incl. due to substance abuse)
1 0 2 3 (10.3%)
Schizophrenia, schizoaffective, schizoprenoform
16 4 1 21 (72.5%)
Affective d-rs 1 0 2 3 (10.3%)
Anxiety d-rs 0 1 1 2 (6.9%)
Personality d-rs 0 0 0 0
Total 18 5 6 29
Psycho stimulant’s abusers n=26
Nonusersn=378
Statistical Analysis df=1
Schizophrenia, schizoaffective, schizoprenoform
21 (80.7%) 200 (52.9%) p=0.001
Affective d-rs 3 (11.5%) 112 (29.6%) p=0.03
Anxiety d-rs 2 (7.7%) 46 (12.2 %) NS
Personality d-rs 0 20 (5.3%) NS
Substance abuse comorbidity in hospitalized psychiatric patients
Psycho stimulant’s abusers vs. nonusers (diagnosis without organic d-rs)
Substance abuse comorbidity in hospitalized psychiatric patientsOpioid abusers vs. nonusers-diagnosis
Opioid abusers n=22
NonusersN=392
Organic d-rs (incl. due to substance abuse)
9 (27.3%) 14 (3.7%)
Schizophrenia, schizoaffective, schizofreniform
7 (31.8%) 200 (51%)
Affective d-rs 5 (22.7%) 112 (28.5%)
Anxiety d-rs 0 46 (11.7%)
Personality d-rs 1 (4.5%) 20 (5.1%)
Substance abuse comorbidity in hospitalized psychiatric patients
Opioid abusers vs. nonusers-diagnosis (without organic) Opioid abusers n=13
NonusersN=378
Statistical Analysis df=1
Schizophrenia,schizoaffective,schizofrenoform
7 (53.8 %) 200 (52.9%) NS
Affective d-rs 5 (38.5%) 112 (29.6%) NS
Anxiety d-rs 0 46 (12.1%) NS
Personality d-rs 1 (7.7 %) 20 (5.3 %) NS
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (positive scale) - cannabis abusers vs. nonusers
Mean Standard deviation
t df p
Cannabisabusersn=54
16.128 8.03054 2.510 466 0.012
Nonusersn= 392
19.0556 8.29962
Substance abuse comorbidity in hospitalized psychiatric patients
PANNS (positive) – subscales: cannabis abusers vs nonusers
P1 (delusions), P2 (conceptual disorganization), P6 (suspiciousness) – rates of the abusers were higher, but not significantly.
Substance abuse comorbidity in hospitalized psychiatric patients PANSS (positive) - subscales: abusers vs.
nonusers
Rates of the abusers were significantly higher then the nonusers:
P3 (hallucinatory behavior) – p=0.011P4 (excitement) – p= 0.004P5 (grandiosity) – p= 0.006P7 (hostility) – p= 0.024
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (general scale) – cannabis abusers vs.
nonusers Mean Standard
deviatn.T df p
Cannabis abusersn=54
33.0185 9.31724 2.727 466 0.007
NonusersN=394
37.3575 11.1955
G5 (mannerism and posturing), G10 (disorientation), G15 (preoccupation) and G16 (active social avoidance) - rates of the abusers were lower, but not significantly.
Substance abuse comorbidity in hospitalized psychiatric patients PANSS (general scale) – subscales: cannabis
abusers vs. nonusers
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (general) – subscales: cannabis abusers vs. nonusers
G9 (unusual thought content), G11 (poor attention), G12 (lack of judgment and insight) - rates of the abusers were higher, but not significantly.
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (general) – subscales: cannabis abusers vs. nonusers
G8 (uncooperativeness) – rates of the abusers were significantly higher
(p=0.001)
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (general) – subscales: cannabis abusers vs. nonusers
Rates of the abusers were significantly lower:G1 (somatic concern) p=0.001G2 (anxiety) p=0.000G3 (guilt feelings) p=0.000G4 (tension) p=0.000G6 (deression) p=0.000G7 (motor retardation) p= 0.001G13 (disturbance of volition) p=0.002G14 (poor impulse control) p=0.001
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (negative scale): cannabis abusers vs. nonusers
Mean Standard deviatn.
t df p
Cannabis abusersn=54
13.8148 6.86763 1.184 466 0.2
Nonusersn=394
14.9831 6.44593
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (negative) – subscales: cannabis abusers vs. nonusers
N3 (poor rapport), N5 (difficulty in abstract thinking) – rates of the abusers were higher, but not significantly.
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (negative) – subscales: cannabis abusers vs. nonusers
N1 (blunted affect), N2 (emotional withdrawal), N6 (lack of spontaneity/conversational flow) – rates of the abusers were lower, but not significantly
Substance abuse comorbidity in hospitalized psychiatric patients
PANSS (negative) – subscales: cannabis abusers vs. nonusers
Rates of the abusers were significantly lower:
N4 (social withdrawal) p= 0.04 N7 (stereotyped thinking) p= 0.037
Substance abuse comorbidity in hospitalized psychiatric patients
YMRS Scale – cannabis abusers vs. nonusers
Mean Standard deviatn.
t df p
Cannabis abusersn=54
6.7778 10.82566 1.158 466 0.115
Nonusersn=394
4.9106 7.754404
Substance abuse comorbidity in hospitalized psychiatric patients
YMRS – subscales: cannabis abusers vs. nonusers
YMRS1 (elevated mood), YMRS2 (increased motor activity), YMRS4 (sleep), YMRS5 (irritability), YMRS6 (speech), YMRS8 (content), YMRS9 (disruptive/aggressive behavior), YMRS10 (appearance) – rates of the abusers were higher, but not significantly.
Substance abuse comorbidity in hospitalized psychiatric patients
YMRS – subscales: cannabis abusers vs. nonusers
YMRS3 (sexual interest) – rates of the abusers were lower, but not significantly
Substance abuse comorbidity in hospitalized psychiatric patients
YMRS – subscales: cannabis abusers vs. nonusers
Rates of the abusers were significantly higher:
YMRS7 (language/thought) – p=0.001 YMRS11 (insight) – p=0.002
Substance abuse comorbidity in hospitalized psychiatric patients HAM-D: cannabis abusers vs. nonusers
Mean Standarddeviatn.
t df p
Cannabisabusersn=54
5.9444 10.2909 3.535 468 0.000
Nonusersn=394
12.8966 13.9465
Substance abuse comorbidity in hospitalized psychiatric patients
HAM-D – subscales: cannabis abusers vs. nonusers
HAM-D13 (general somatic symptoms) and HAM-D20 (paranoid symptoms) – rates of the abusers were higher, but not significantly
Substance abuse comorbidity in hospitalized psychiatric patients
HAM-D – subscales: cannabis abusers vs. nonusers
Rates of the abusers were lower, but not significantly:
HAM-D5 (middle insomnia)HAM-D7 (work and activities)HAM-D15 (hyposhondriasis)HAM-D16 (lost of weight)HAM-D17 (insight)HAM-D19 (depersonalization and derealization)
Substance abuse comorbidity in hospitalized psychiatric patients
HAM-D – subscales: cannabis abusers vs. nonusers
Rates of the users were significantly lower:HAM-D1 (depressed mood) – p=0.000HAM-D2 (feeling of guilt) – p=0.000HAM-D3 (suicide) – p=0.011HAM-D4 (early insomnia) – p=0.000HAM-D6 (late insomnia) – p=0.006HAM-D8 (retardation) – p=0.006HAM-D9 (agitation) – p=0.000HAM-D10 (psychotic anxiety) – p=0.000
Substance abuse comorbidity in hospitalized psychiatric patients
HAM-D – subscales: cannabis abusers vs.nonusers (continued)
Rates of the abusers were significantly lower: HAM-D11(somatic anxiety) – p=0.000HAM-D12 (somatic symptoms-gastrointestinal) –
p=0.006HAM-D14 (somatic symptoms-genital) – p=0.002HAM-D18 (diurnal variation) – p=0.01HAMD-D21 (obsessive and compulsive symptoms) –
p=0.002
Substance abuse comorbidity in hospitalized psychiatric patients
PANNS (positive scale) – stimulants abusers vs. nonusers
Mean Standarddeviatn
t df p
Stimulantsabusersn=29
19.0 9.29606 1.609 466 0.11
Nonusersn=394
16.3228 8.02299
Substance abuse comorbidity in hospitalized psychiatric patients
PANNS (negative scale) – stimulants abusers vs. nonusers
Mean Standarddeviatn
t df p
Stimulantsabusersn=29
14.8691 6.88043 0.277 466 0.78
Nonusersn=394
14.4800 5.83895
Substance abuse comorbidity in hospitalized psychiatric patients
PANNS (general scale) – stimulants abusers vs. nonusers
Mean Standarddeviatn
t df p
Stimulantsabusersn=29
39.9097 11.17572 0.434 466 0.664
Nonusersn=394
35.920 9.21466
Substance abuse comorbidity in hospitalized psychiatric patients
YMRS scale – stimulants abusers vs. nonusers
Mean Standarddeviatn
t df p
Stimulantsabusersn=29
5.2400 7.67181 0.072 466 0.943
Nonusersn=394
5.1196 8.21056