Data from: Use of novel psychoactive substances by inpatients on general adult psychiatric wards

Objectives: Non-illicit alternatives to controlled drugs, known as Novel Psychoactive Substances (NPS) have recently risen to prominence. They are readily available with uncertain pharmacology and no widely available assay. Given that psychiatric patients are at risk of comorbid substance abuse, we hypothesized that NPS use would be present in the psychiatric population, and sought to determine its prevalence and investigate the characteristics of those who use these drugs with a retrospective review of discharge letters. Setting: General adult inpatient wards of a psychiatric hospital in a Scottish city. Participants: All adult inpatients (18-65) discharged from general psychiatric wards between 1/7/14 and 31/12/14. 483 admissions identified, 46 were admissions for maintenance ECT and were excluded. Of the remaining 437 admissions, 49 discharge letters were unobtainable, leaving 388 admissions to analyze. Primary outcome measure: The mention or lack thereof of NPS use in discharge letters was our planned primary outcome measure and was also the primary outcome measure we used in our analysis. Results: NPS use was identified in 22.2% of admissions, contributing to psychiatric symptoms in 59.3%. In comparison to non-users, NPS users were younger (p<0.01), male and more likely to have a forensic history ((p<0.001) for both). The diagnosis of drug-induced psychosis was significantly more likely in NPS users (p<0.001, odds ratio (OR) 18.7, 95% confidence intervals (CI) 8.1-43.0) and the diagnosis of depression was significantly less likely (p<0.005, OR 0.133, CI 0.031-0.558). Use of cannabis was significantly more likely in NPS users (p<0.001, OR 4.2, CI 2.5-7.1), as was substitute opiate prescribing (p<0.001, OR 3.7, CI 1.8-7.4). Conclusions: NPS use was prevalent amongst young, male psychiatric inpatients; in particular those with drug induced psychosis and often occurred alongside illicit drug use.研究目的：受管制药物的非违禁替代物质——新型精神活性物质（Novel Psychoactive Substances, NPS）近年来日益受到关注。此类物质易于获取，但药理学特性尚不明确，且尚无广泛可用的检测手段。鉴于精神疾病患者共病物质使用障碍的风险较高，我们假设精神科人群中存在新型精神活性物质使用情况，并拟通过回顾性分析出院病历，明确其流行率并探究此类使用者的人群特征。 研究场景：苏格兰某城市一所精神专科医院的成人普通住院病房。 研究对象：2014年7月1日至2014年12月31日期间，于精神科普通住院病房出院的所有成年住院患者（年龄18~65岁）。共纳入483例次住院记录，其中46例次为维持性电抽搐治疗（Electroconvulsive Therapy, ECT）住院，予以排除。剩余437例次住院记录中，49份出院病历无法获取，最终纳入388例次进行分析。 主要结局指标：出院病历中提及新型精神活性物质使用与否，为本研究预设的主要结局指标，同时也是本次分析所采用的主要结局指标。 结果：22.2%的住院记录中检出新型精神活性物质使用情况，其中59.3%的病例中此类物质使用与精神症状的发生或加重相关。与未使用者相比，新型精神活性物质使用者年龄更小（p<0.01）、男性占比更高，且既往有司法前科的比例显著更高（两项指标p均<0.001）。新型精神活性物质使用者被诊断为药物所致精神病的风险显著更高（p<0.001，优势比（odds ratio, OR）=18.7，95%置信区间（confidence intervals, CI）：8.1~43.0），而被诊断为抑郁症的风险则显著更低（p<0.005，OR=0.133，95%CI：0.031~0.558）。此类使用者同时使用大麻的比例显著更高（p<0.001，OR=4.2，95%CI：2.5~7.1），接受替代阿片类药物处方的比例同样显著更高（p<0.001，OR=3.7，95%CI：1.8~7.4）。 结论：新型精神活性物质使用在年轻男性精神科住院患者中较为普遍，尤其多见于药物所致精神病患者，且此类使用常与违禁药物使用并存。