Prevalence of dependence on prescription drugs and associated mental disorders in a representative sample of general hospital patients

Objectives: The aim of this study was to determine the prevalence of dependence on prescription drugs (DPD) and associated comorbid disorders in consecutive general hospital inpatients. Methods: The sample consisted of 952 volunteer patients (age range, 18 to 64 years) in a German general hospital. The screening instrument was a self-administered questionnaire. A personal interview containing the Structured Clinical Interview for DSM-IV (SCID, Axis I) was used to evaluate positive screening results and to diagnose comorbid disorders. Results: The current prevalence of DPD was 4.7% [95% confidence interval (CI), 3.40-6.18; n=45). The current prevalence of single sedative dependence was 1.4% (95% CI, 0.62-2.14); of single hypnotic dependence, 1.2% (95% CI, 0.47-1.87); and of painkillers, 1.3% (95% CI, 0.54-2.01). In addition, dependence on sedatives and hypnotics was found in 0.1% of screened patients, painkillers and sedatives in 0.2%, painkillers and hypnotics in 0.4% and all three substances in 0.2%. Women were slightly overrepresented. The average age was 50.3 years. Psychiatric Axis I comorbidities were diagnosed in 66.7% of all cases, mostly anxiety disorders, followed by comorbid substance use and affective disorders. Conclusion: The results indicate that the prevalence of DPD in general hospitals is frequent and should therefore become an important subject for health care providers. The general hospital might serve as an appropriate setting to provide early interventions for this group of patients.