Acute Care/Hospitalization

Substance abuse is linked to readmissions for mood disorders

About 21 million American adults suffer from mood disorders, including major depression and bipolar disorder. When people with mood disorders are hospitalized for treatment, between 20 and 50 percent of them return to the hospital within a year. Researchers at the Rutgers University Center for Education and Research on Therapeutics (CERT) analyzed Medicaid claims data from five States and found that nearly a quarter of people with major depression, bipolar disorder, or both conditions were hospitalized from 1999 to 2000. Thirty-six percent of those who were hospitalized also had received diagnoses of alcohol or drug abuse.

Twenty-four percent of the people hospitalized with mood disorders were rehospitalized within 3 months after they were discharged. Half (50 percent) of those who were rehospitalized also had received diagnoses of drug or alcohol abuse. People with mood disorders who abused drugs had an adjusted readmission hazard rate that was 58 percent greater than those who did not abuse drugs, and people with mood disorder who abused alcohol had an adjusted readmission rate that was 46 percent greater than those who did not abuse alcohol.

The authors suggest that people suffering from major depression and bipolar disorder, who also abuse drugs or alcohol, might be able to avoid hospitalizations and rehospitalizations if their substance abuse, mental health, and medical care services are better integrated so that they receive appropriate care.

This study was funded in part by a grant from the Agency for Healthcare Research and Quality (HS16097) to the Rutgers University CERT. For more information on the CERTs program, please visit http://certs.hhs.gov/index.html.

See "Substance abuse and hospitalization for mood disorder among Medicaid beneficiaries," by Jonathan D. Prince, Ph.D., Ayse Akincigil, Ph.D., Donald R. Hoover, Ph.D., and others in the January 2009 American Journal of Public Health 99(1), pp. 160-167.

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