Predictors of Psychiatric Hospitalization in Ex-Prisoners With Substance Use Problems

Abstract

This study analyzed predictors of psychiatric hospitalization in ex-prisoners with substance use problems ( N = 4,081) assessed with the Addiction Severity Index and followed post-release for hospitalizations with psychiatric diagnoses (including suicide attempts). Thirty-four percent were hospitalized, and in Cox regression, several substance-related variables predicted hospitalization, including use of heroin, sedatives, and polysubstance. A secondary analysis, with a psychiatric non-substance focus, excluded hospitalizations involving only substance-related disorders or only a personality disorder in addition to a substance-related disorder. With this definition, 10% were hospitalized, and significant baseline predictors were previous psychiatric hospitalization (hazard ratio [HR] = 1.83), previous suicide attempt (HR = 1.91), depression (HR = 1.33), anxiety (HR = 1.37), sedative use (HR = 1.46), and, negatively, amphetamine use (HR = 0.71). Substance-related variables may predict all-cause psychiatric hospitalizations in prisoners with substance use problems, whereas non-substance-related psychiatric hospitalization may be predicted by baseline psychiatric problems, which calls for attention to psychiatric problems in this setting.