The Effects of Cannabis on Inpatient Agitation, Aggression, and Length of Stay
| Autor: | Gerald Scott Winder, Chris Y. Wu, Jolene R. Bostwick, Joseph M. Johnson, Vincent D. Marshall, Michael I. Casher |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Psychosis medicine.medical_specialty Bipolar Disorder Schizoaffective disorder 03 medical and health sciences 0302 clinical medicine mental disorders medicine Humans Bipolar disorder Psychiatry Psychomotor Agitation Effects of cannabis Cannabis Retrospective Studies Inpatients Positive and Negative Syndrome Scale business.industry Not Otherwise Specified Length of Stay medicine.disease 030227 psychiatry Aggression Psychiatry and Mental health Psychotic Disorders Schizophrenia Female Schizophrenic Psychology business 030217 neurology & neurosurgery Diagnosis of schizophrenia |
| Zdroj: | Journal of Dual Diagnosis. 12:244-251 |
| ISSN: | 1550-4271 1550-4263 |
| DOI: | 10.1080/15504263.2016.1245457 |
| Popis: | This study examines the association between cannabis use and the hospital course of patients admitted to the psychiatric inpatient unit with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder. Many confounding variables potentially contribute to the clinical presentation of hospitalized patients in the psychiatric unit. Illicit drug use, in particular, has been associated with acute agitation, and questions can be raised as to what lasting effects drug use prior to admission may have throughout a patient's hospital stay.Subjects with a discharge diagnosis of bipolar disorder, schizophrenia, schizoaffective disorder, or psychosis not otherwise specified (N = 201) were retrospectively identified, and those with positive results of urine drug screen for cannabis on admission were compared to negative counterparts. Agitation and aggression were measured using an adaptation of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC). These markers were also quantified by comparing charted episodes of restraint and seclusion and administration of as needed medications, such as benzodiazepines and antipsychotics.Positive urine drug screen results for cannabis was correlated with young (p = .001) males (p = .003) with bipolar disorder (p = .009) exhibiting active manic symptoms (p = .003) at the time of admission. Cannabis use was further associated with a shorter length of stay (p = .008), agitation triggering adapted PANSS-EC nursing assessments (p = .029), and oral medications as needed (p = .002) for agitation.Cannabis use, as defined by positive urine drug screen results, was more common in patients with bipolar disorder and was accompanied by a higher incidence of inpatient agitation. Although these patients also had short hospital lengths of stay, there was no clear relationship between level of agitation and length of stay across all patient groups. One possible explanation for patients with bipolar disorder experiencing short lengths of stay is that their source of agitation may be more closely related to a complex effect of cannabis use rather than a sole etiology of mental illness. Inpatient clinicians should be aware of patient cannabis use proximate to admission. |
| Databáze: | OpenAIRE |
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