Previous psychiatric hospitalizations as risk factors for single and multiple future alcohol-related hospitalizations in patients with alcohol use disorders

Manca, F. and Lewsey, J. (2024) Previous psychiatric hospitalizations as risk factors for single and multiple future alcohol-related hospitalizations in patients with alcohol use disorders. Addiction, 119(2), pp. 291-300. (doi: 10.1111/add.16352) (PMID:37750192)

Abstract

Background and aims: People with alcohol use disorder (AUD) often have co-occurring psychiatric conditions. The association between psychiatric conditions and AUD relapse has not yet been fully explored. This study aimed to quantify different psychiatric comorbidities as risk factors for first and multiple AUD rehospitalizations in patients already hospitalized once for AUD. Methods: We used a nation-wide routine health-care database in Scotland, UK, between 2010 and 2019. Individuals with a first hospitalization for AUD (codes F10.0-9 in the ICD-10 codes) were checked for previous hospitalizations where the main or co-occurring cause was a psychiatric condition (any other F0-F99 code in ICD-10). The final cohort included 23 529 patients, 18 620 of whom did not have a history of any other psychiatric comorbidity. First, individuals with a history of any previous psychiatric hospitalization were grouped and compared with those without on the basis of time to AUD rehospitalization. Then, individuals with different histories of psychiatric hospitalization were compared with each other. Cox and Prentice, Williams and Peterson gap-time models were used for single and multiple AUD rehospitalizations, respectively. Results: The AUD rehospitalization rate in individuals with a previous psychiatric hospitalization was 8% higher compared with those without [hazard ratio (HR) = 1.08, 95% confidence interval (CI) = 1.01–1.14]. The difference in rehospitalization rate reduced following the first rehospitalization (HR at second rehospitalization from first: 0.95, 95% CI = 0.87–1.04 and HR at third rehospitalization from second: 0.94, 95% CI = 0.84–1.07). Mood disorders and neurotic, stress-related and somatoform disorders were associated with a 54% (HR = 1.54, 95% CI = 1.38–1.72) and 39% (HR = 1.39, 95% CI = 1.17–1.66) increase in the risk of a first AUD rehospitalization. Other conditions, such as disorders due to psychoactive substance use or schizophrenia, were associated with decreases in future AUD rehospitalization (HR = 0.89, 95% CI = 0.82–0.97 and HR = 0.82, 95% CI = 0.58–1.16, respectively). Conclusions: Patients with AUD appear to have different rates of AUD rehospitalization based on different co-occurring psychiatric conditions. Addiction-related characteristics may be more relevant risk indicators for multiple AUD readmission than psychiatric comorbidities.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lewsey, Professor Jim and Manca, Mr Francesco

Creator Roles

Manca, F.: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Visualization, Writing – original draft, Writing – review and editing
Lewsey, J.: Methodology, Supervision, Writing – review and editing

• Authors: Manca, F., and Lewsey, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Journal Name: Addiction
• Publisher: Wiley
• ISSN: 0965-2140
• ISSN (Online): 1360-0443
• Published Online: 26 September 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Addiction 119(2):291-300
• Publisher Policy: Reproduced under a Creative Commons license