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Inpatients in substance use treatment with co-occurring psychiatric disorders: a prospective cohort study of characteristics and relapse predictors
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BACKGROUND: The characteristics of substance use disorder (SUD) inpatients with co-occurring psychiatric disorders (COD) have been scantly described in the extant literature. This study investigated psychological, demographic and substance use characteristics in these patients, along with predictors of relapse 3 months post-treatment. METHODS: Prospective data from a cohort of 611 inpatients were analyzed for demographics, motivation, mental distress, SUD diagnosis, psychiatric diagnoses (ICD-10) and relapse rate at 3 months post-treatment (retention rate = 70%). RESULTS: Compared to patients without COD (n = 322), those with COD (n = 289) were younger, had higher mental distress, lower education and higher likelihood of no permanent residence. The relapse rate was also higher in patients with COD (39.8%) relative to patients without COD (26.4%) (OR = 1.85, 95% CI: 1.23-2.78). The relapse rate was particularly high for patients with COD who were diagnosed with cannabis use disorder (53.3%). Multivariate analysis revealed that among patients with COD, relapse was more likely for individuals with a cannabis use disorder (OR = 2.31, 95% CI: 1.34-4.00), and less likely for older ages (OR = 0.97, 95% CI: 0.94-1.00), females (OR = 0.56, 95% CI: 0.33-0.98) and for those with higher intrinsic motivation (OR = 0.58, 95% CI: 0.42-0.81). CONCLUSION: This study showed that among SUD inpatients, those with COD had relatively persistent high levels of mental distress and an increased risk of relapse. Enhanced measures aimed at COD patients' mental health problems during the inpatient stay, along with close and personalized follow-up after discharge from residential SUD treatment may reduce the probability of relapse in this group.
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“Co‐occurrence is consistently associated with greater symptom severity, higher relapse rates, poorer treatment adherence and increased mortality compared to either condition alone [5].”
From Treatment Experiences of Individuals With Co-Occurring Mental Health and Substance Use Disorders and Perspectives of Mental Health Workers in Ashanti Region, Ghana (2026) · cites this paper as [5]
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Metadata
- Authors
- Andersson, H. W., Mosti, M. P., & Nordfjaern, T.
- Affiliations
- St Olav's University Hospital (NO)
- Corresponding author
- Andersson, Helle Wessel
- Venue
- BMC Psychiatry
- Published
- 2023-03-09
- Volume
- 23
- Issue
- 1
- Pages
- 152-152
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC9999667
- OpenAlex
- W4323655160
- Cited by
- 35
- References
- 51
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 7 · 2023: 3
- FWCI
- 6.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- NTNU Norwegian University of Science and Technology
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- substance use disorders, co-occurring psychiatric disorders, relapse, inpatient care, cannabis use disorder, intrinsic motivation, psychological distress, treatment retention, residential addiction treatment, post-discharge follow-up
- MeSH terms
- Mental Disorders, Marijuana Abuse, Chronic Disease, Female, Humans, Inpatients, Prospective Studies, Recurrence, Comorbidity, Substance-Related Disorders
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