Twenty percent of psychiatric inpatients have co-morbid substance abuse/dependence and their management is challening.

To investigate co-morbidity and patterns of substance use among inpatients in a general psychiatric unit.

To examine specific patterns and risk factors associated with substances/alcohol in psychiatric inpatients.

Participants included 487 inpatients consecutively admitted to the Psychiatric Unit, University Hospital of Crete between Nov 2011- Jun 2013. Data were analyzed using the Pearson's chi-square test and multiple regression.

Our sample, mean age 42.7±14.5yrs, consisted of 57.9% males, whereas 51.9% were admitted involuntarily. In addition, 60.3% were unemployed, 24.3% had a spouse and 38.1% had no previous psychiatric hospitalizations. Furthermore, 354 (72.8%) used no substances, while 16.1% used alcohol, 12.3% cannabis, 3.8% opioids, 2.5% cocaine, and 5.5% anxiolytics. Mean age of those abusing alcohol was 41.8yrs, cannabis 34.1yrs, opioids and cocaine 31.6yrs and anxiolytics 36.9yrs. In patients with Major Depression, alcohol (21.1%) and anxiolytics (9.8%) were the most prevalent, whereas, in patients with psychotic disorders and bipolar disorders, alcohol (9.8% and 5.8% respectively) and cannabis (11.9% and 15.2%) were the most frequent. Unemployment, and involuntary admission weren’t significant risk factors for alcohol/substance use.

Substance/alcohol abuse/dependence is present in 1/3 of our psychiatric population with alcohol, cannabis and anxiolytics the most commonly used. Alcohol was more frequent in older patients with depression, whereas cannabis was more frequent in younger patients with psychotic/bipolar disorder. Development of dual diagnosis centers, very scarce in Greece, are needed for the management of psychiatric patients with substance co-morbidity.