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Examining Substance Use Disorders and Mental Health Comorbidities in Patients Hospitalized for Schizophrenia and Bipolar Disorders

Slaughter, Mary E
http://rave.ohiolink.edu/etdc/view?acc_num=case1517851653320388

Abstract Details

2018, Doctor of Philosophy, Case Western Reserve University, Epidemiology and Biostatistics.
Background: Legalization of medical and recreational marijuana can lead to increases in marijuana use disorder (MUD). Many studies have found that substance use disorders and alcohol use disorders exacerbate negative symptoms in patients with schizophrenia spectrum disorder (SSD) and bipolar disorder (BPD). Few studies have examined the relationship between hospital related outcomes and comorbid MUD separate from alcohol and other substances in patients with SSD or BPD. Aim: The goal of this research was to examine the association between MUD and hospital related outcomes for patients with SSD and BPD. We examined hospital readmissions, suicide attempts, costs and length of stays. Furthermore, we sought to examine interactions between substance use disorders and other mental health comorbidities in patients with BPD. Methods: We used data from the Healthcare Utilization Project from California to identify patients with a primary diagnosis of SSD or BPD. Substance use disorders were identified using ICD-9-CM diagnostic codes at the time of SSD or BPD visit or 90 days prior. Patients were censored at the end of 2011 if they did not have a readmission or suicide attempt. We used Cox Proportional Hazards models to estimate readmission and suicide attempt risk and general linear models to model cost and length of stay. Results: Comorbid alcohol and other drug use disorders apart from marijuana increased risk for readmission in both patients with SSD and BPD. Suicide attempt risks were also elevated in BPD patients with comorbid non-marijuana substance use disorders. Patients with SSD and comorbid MUD had a lower readmission risk, however sensitivity analyses did not sustain this effect. Patients with BPD and anxiety disorder had a lower risk of readmission if they had comorbid MUD. This effect was sustained in sensitivity analyses. Length of stay and costs were lower for patients with any comorbid substance use disorder. Conclusions: Patients with SSD and BPD who have comorbid MUD do not have increased risks for readmission or suicide attempt and may, for BPD patients with comorbid anxiety disorder, have a lower risk. Further research on the underlying mechanisms lowering risks for patients with comorbid MUD would be of interest.
Mendel Singer, Ph.D. (Advisor)
Siran Koroukian, Ph.D. (Committee Chair)
Mark Singer, Ph.D. (Committee Member)
Kathleen Smyth, Ph.D. (Committee Member)
Coreen Farris, Ph.D. (Committee Member)
98 p.
Epidemiology; Mental Health
schizophrenia; bipolar disorder; alcohol use disorder; marijuana use disorder; drug abuse; drug dependence; hospital readmissions; HCUP;

Recommended Citations

Citations

  • Slaughter, M. E. (2018). Examining Substance Use Disorders and Mental Health Comorbidities in Patients Hospitalized for Schizophrenia and Bipolar Disorders [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1517851653320388

    APA Style (7th edition)

  • Slaughter, Mary. Examining Substance Use Disorders and Mental Health Comorbidities in Patients Hospitalized for Schizophrenia and Bipolar Disorders. 2018. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1517851653320388.

    MLA Style (8th edition)

  • Slaughter, Mary. "Examining Substance Use Disorders and Mental Health Comorbidities in Patients Hospitalized for Schizophrenia and Bipolar Disorders." Doctoral dissertation, Case Western Reserve University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1517851653320388

    Chicago Manual of Style (17th edition)

case1517851653320388
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© 2018, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.