South African Medical Journal

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Substance misuse in youth admitted to a psychiatric emergency unit

DAB Wilson, A J Flisher, R Allin, J A Laubscher


Objectives. To investigate the pattern of substance misuse in youth admitted to a psychiatric emergency unit of a 'major hospital, and to compare regular users of cannabis,methaqualone and alcohol with the rest of the sample in terms of selected psychosocial variables.
Study population. Consecutive patients aged 25 years or younger admitted to a psychiatric emergency unit over a 3month period.
Method. Patients completed a standardised questionnaire .containing questions about their family, social, economic and educational backgrounds. Their current psychiatric folder was examined to ascertain mental state and behaviour on admission as well as previous psychiatric contacts and hospitalisation. Particular attention was paid to the use of cannabis, methaqualone and alcohol For each substance patients were divided into two groups, namely those who did not use the substance or who used it infrequently, and regular users. Unadjusted odds ratios were used to document the relationship between substance use and the selected psychosocial variables
Results. One hundred and fourteen patients were assessed, of which number 61 (53.5%) were male and 98 (86%) were single. The group consisted of 37 blacks (32.5%), 56 coloureds (49.1%) and 21 whites (18.4%)_ Alcohol was . regularly used by 30 patients (263%), cannabis by 29 (25.4%), methaqualone by 11 (9.6%), and any-of these substances by 46 patients (40.4%). Unadjusted odds ratios showed that there was a significant association between regular use of alcohol and cannabis and male gender, dropping out of school, previous psychiatric treatment, and an absence of both depression and suicidal ideation; and between regular cannabis use and bizarre behaviour, auditory hallucinations and disorganised or incoherent speech. Methaqualone use was associated with hostile threats.
Conclusions. In the study population substance use was associated with various adverse psychosocial circumstances; these may alert the practitioner to the possibility of substance use. Cannabis misuse was suggested by behavioural, perceptual and speech abnormalities on mental state examination.

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