Je. Kirchner et al., DIAGNOSIS AND MANAGEMENT OF SUBSTANCE USE DISORDERS AMONG INPATIENTS WITH SCHIZOPHRENIA, Psychiatric services, 49(1), 1998, pp. 82-85
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.