COMORBID SUBSTANCE-ABUSE AND RECOVERY FROM ACUTE PSYCHIATRIC RELAPSE

Objective: The study investigated whether chronic mentally ill Patient s whose psychiatric relapse was complicated by active substance abuse recovered from relapse at a different rate than similar patients with no comorbid substance abuse. Methods: A total of 401 patients involunt arily hospitalized on a short-term psychiatric treatment unit received a urine toxicology screen on admission; the severity of their psychia tric symptoms was rated on the fifth day of hospitalization using the Brief Psychiatric Rating Scale (BPRS). Differences in scores between p atients who had positive screens and those who had negative screens we re evaluated for various diagnostic groups. Results: Patients who had a positive screen and a primary discharge diagnosis of psychoactive su bstance abuse had a BPRS total score indicating less psychopathology t han similarly diagnosed patients with negative screens. Patients who h ad positive screens and a diagnosis of personality disorder had some B PRS subscale scores indicating greater psychopathology than their coun terparts with negative screens. No other significant differences in re covery rates between the two groups were found, although comparisons i ndicated trends toward faster recovery in some areas of functioning by schizophrenic patients with positive screens and affective disorder p atients with negative screens. Conclusions: Results suggest that use o f a urine toxicology screen and the BPRS early in treatment may aid in assessing the acute course of several psychiatric disorders and the e ffect of comorbidity.