Prevalence rate and clinical predictors of substance use disorders in psychiatric patients assessed in the emergency department of a Tertiary Hospital in Northern Alberta

Background: There is only a limited body of literature which has examined the factors which can predict the presence of Substance Use Disorders (SUD) in psychiatric patients seeking Emergency Room (ER) treatment. Objective: To determine the prevalence rates for SUD and to examine the factors that can predict the likelihood that a patient presenting to the Emergency Room and referred to the liaison psychiatric team will suffer from a SUD. Methods: Nineteen independent demographic and clinical factors from data assessment tools for 477 patients assessed by the liaison psychiatric team in the ER over 12 months were compiled and analysed using univariate analyses and logistic regression in SPSS Version 20. Results: The 12 month prevalence rate of all SUDs in our clinical sample was 24.7%. Patients who presented to the ER with a chief alcohol and/or drug related complaint (withdrawal or intoxication) were 142 times more likely to fulfill the diagnostic criteria for SUD compared to those who presented with non-SUD related complaints. Male patients or patients with forensic history were both three times more likely to suffer from SUD than female patients or patients with no forensic history, respectively. Patients with a history of non-adherence, those living in camps and homeless patients were also more likely to have a SUD. Conclusion: There is a high prevalence of SUDs among psychiatric patients assessed in the ER. Our study adds to the literature by using Canadian ER data to confirm previous international research which suggests associations between SUD and male gender, criminal conviction, history of non-adherence to medication, living in camps and homelessness.