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35th AM (2025) - Poster Session
Impact of Co-Occurring Substance Use Disorder on P ...
Impact of Co-Occurring Substance Use Disorder on Psychiatric Readmission in Patients Treated with Long-Acting...
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Pdf Summary
This retrospective chart review studied the impact of co-occurring substance use disorders (SUDs) on psychiatric readmission among patients with severe and persistent mental illness (SPMI) treated with long-acting injectable antipsychotics (LAIs). The study included patients hospitalized between January 2020 and October 2022 at Mount Sinai who received LAIs. Data on socioeconomic, psychiatric, and substance use factors were extracted from medical records, with patients categorized by readmission status within one year post-discharge.<br /><br />Key findings revealed that readmitted patients were more likely to have public insurance, use sedative-hypnotics, have multiple prior hospitalizations, be discharged on dual antipsychotics, be discharged to higher levels of care, and have received first-generation antipsychotic LAIs. Notably, sedative-hypnotic use was strongly associated with increased readmission risk (5.4 times higher). Conversely, co-occurring cannabis or synthetic cannabinoid use was surprisingly linked to a decreased likelihood of readmission, potentially due to reduced withdrawal-related psychiatric exacerbations or diagnostic misclassification. Other substances, including alcohol, stimulants, opioids, and hallucinogens, did not significantly affect readmission rates, though this may reflect limited psychiatric care access rather than illness severity.<br /><br />A logistic regression model identified independent predictors of readmission: sedative/hypnotic use, cannabis/cannabinoid use, high level of outpatient care engagement, history of prior hospitalizations, and discharge on dual antipsychotics. The study suggests that while LAIs generally reduce rehospitalizations in SPMI patients regardless of overall substance use, specific substances like sedative-hypnotics require targeted outpatient management to prevent relapse. These findings underscore the complexity of managing co-occurring SPMI and SUDs and highlight the need for integrated, multidisciplinary care tailored to substance use profiles to optimize outcomes.
Keywords
substance use disorders
severe persistent mental illness
long-acting injectable antipsychotics
psychiatric readmission
sedative-hypnotics
cannabis use
dual antipsychotics
hospitalization history
outpatient care engagement
integrated multidisciplinary care
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