Contextualizing the Relationship Between Social Isolation and Substance Abuse.

Objective: To investigate the relationship between social isolation and substance abuse among adult hospitalizations to better target prevention and intervention.Methods: The 2018 National Inpatient Sample dataset was used to identify adult hospitalizations with social isolation and substance abuse in the United States, omitting long-term and rehabilitation facilities. The study analyzed sociodemographic features and health care resource utilization, with primary end points focusing on the prevalence of substance use disorder (SUD) with social isolation and sex/race-based disparities and secondary end points including mental health and costs. Comparisons were analyzed using SPSS Statistics with weighted data and complex survey modules.Results: The study included 2,050 patients (median age: 48 years, male: 55.6%) with an International Classification of Diseases, Tenth Revision, Clinical Modification social isolation diagnostic code, of which 16.6% had SUD, with higher prevalence in those of younger age, male sex, and black race. Smoking (49.3% vs 36.1%), alcohol disorder (14.4% vs 4.9%), cannabis disorder (14.6% vs 1.4%), stimulant-related disorder (16.3% vs 2.6%), and opioid-related disorder (16.6% vs 3.1%) were the most prevalent SUDs among socially isolated patients. The length of stay was similar among socially isolated patients by substance use; however, hospitalization cost was higher ($6,144 vs $4,745) among patients with SUD.Conclusion: The link between social isolation and substance use highlights the significance of addressing social isolation as a public health issue. Interventions to nurture social ties and reduce social isolation may have significant potential in preventing and managing SUDs.Prim Care Companion CNS Disord 2024;26(5):23m03679. Author affiliations are listed at the end of this article.

Traumatic Brain Injury and Risk of Schizophrenia and Other Non-mood Psychotic Disorders: Findings From a Large Inpatient Database in the United States.

BACKGROUND: Traumatic brain injury (TBI) is linked with an increased risk of schizophrenia and other non-mood psychotic disorders (psychotic disorders), but the prevalence and contributing factors of these psychiatric conditions post-TBI remain unclear. This study explores this link to identify key risk factors in TBI patients. METHODS: We used the 2017 National Inpatient Sample dataset. Patients with a history of TBI (n = 26 187) were identified and matched 1:1 by age and gender to controls without TBI (n = 26 187). We compared clinical and demographic characteristics between groups. The association between TBI and psychotic disorders was explored using the logistic regression analysis, and results were presented as Odds ratio (OR) and 95% confidence interval (CI). RESULTS: Psychotic disorders were significantly more prevalent in TBI patients (10.9%) vs controls (4.7%) (P < .001). Adjusted odds of psychotic disorders were 2.2 times higher for TBI patients (95% CI 2.05-2.43, P < .001). Male TBI patients had higher psychotic disorders prevalence than females (11.9% vs 8.4%). Younger age, bipolar disorder, anxiety disorders, substance abuse, personality disorders, and intellectual disability are associated with an increased risk of psychotic disorders in men. CONCLUSION: Our study found that hospitalized TBI patients had 2.2 times higher odds of Schizophrenia non-mood psychotic disorder, indicating an association. This highlights the need for early screening of psychotic disorders and intervention in TBI patients, calling for more research.

High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) in the First Episode of Catatonia: A Series of Four Cases.

Four patients with benzodiazepine non-responsive catatonia were administered repetitive transcranial magnetic stimulation (rTMS) at the left dorsolateral prefrontal cortex at 120% of resting motor threshold, frequency of 10Hz, with a total of 3,000 pulses/session. Patients with mood disorders showed good responses. One patient with chronic resistant schizophrenia had worsening catatonic symptoms during rTMS that responded to electroconvulsive therapy. Maximum response was observed between sessions 8 and 12.

Prevalence of Substance use disorder among young adults hospitalized in the US hospital: A decade of change.

INTRODUCTION: Mental health disorders (MHD) and substance use disorders (SUD) lead to outstanding socioeconomic costs and increased hospital visits. However, very few studies have quantified this trend over time and across specific conditions. ​​Our study aims to investigate and compare the prevalence of MHDs and SUDs in hospitalizations between 2007 and 2017. METHODS: We used hospital records for 2007 and 2017 from the National Inpatient Sample (NIS) datasets to identify young adults (18-44 years) hospitalized with MHD and SUD. The prevalence of MHD in hospitalized patients in 2017 vs. 2007 was measured and compared. We generated a multivariable logistic regression analysis controlled for confounders, including age, sex, race, and payer status. We evaluated these outcomes using Odds Ratio (OR) and 95% Confidence Interval (CI). RESULTS: A total 10,353,890 patients were included in 2007, and 8,569,789 patients were included in 2017. The prevalence of drug abuse among hospitalized patients was 8.4% in 2017 vs. 6.2% in 2007. Prevalence increased in both genders (15.7% vs. 13.0% among male, 5.7% vs. 3.9% among females) in 2017 vs. 2007. All psychiatric disorders showed a higher prevalence in 2017 compared to 2007. When stratified by race, the prevalence of substance use disorder increased among all races except Black race between 2017 vs. 2007. On multivariable analysis, widespread drug abuse was significantly associated with hospital admissions in 2017 vs. 2007 (OR: 1.27, 95% CI: 1.20-1.34, p<0.001). These associations held across many substance abuse cases and mental health disorders except cocaine abuse (OR: 0.84, 95%CI: 0.76-0.93, p<0.001). CONCLUSION: There was a significant rise in substance use disorder and psychiatric disorder a decade later, from 2007, in hospitalized patients in the age group 18-44 years. The most increase was observed in amphetamine use disorder and anxiety disorder. Suicide and intentional self-inflicted injury increased in all races, with a maximum increase observed in Native Americans. Further studies evaluating the factors responsible for this upward trend would be beneficial.