DIAGNOSIS AND MANAGEMENT OF SUBSTANCE USE DISORDERS AMONG INPATIENTS WITH SCHIZOPHRENIA

Objective: The study examined the extent of clinical recognition of co morbid substance use disorders and the clinical management of these di sorders among inpatients hospitalized for an acute exacerbation of sch izophrenia. Methods: medical records of 42 inpatients who met research diagnostic criteria for both schizophrenia and a current substance us e disorder were reviewed for information about admission evaluation, i npatient management, discharge diagnosis, and disposition. Results: Al cohol use disorders were the most frequent co-occurring substance-rela ted diagnoses, found for 86 percent of the dually diagnosed inpatients . Twenty-four patients (57 percent) did not receive a diagnosis of a s ubstance-related disorder at admission, and 19 (45 percent) did not re ceive a substance-related diagnosis at discharge. Referral to inpatien t or outpatient substance abuse treatment was documented for a minorit y of subjects. Conclusion: The results suggest that improvements are n eeded in the process of clinical care for inpatients with schizophreni a who have co-occurring substance-related disorders. They highlight a need for education of health care providers and continuous quality imp rovement in this area.