The role of psychiatric comorbidity in the prediction of readmission for detoxification.

In a prospective study over a 28-month period in Iceland using a representative sample (N = 351), the association among patients seeking detoxification between comorbid psychopathology and (1) number of lifetime admissions, (2) readmissions for detoxification, and (3) a "revolving-door" career (i.e., at least four admissions within 30 months) was studied. Psychiatric diagnoses were assigned using the Diagnostic Interview Schedule (DIS), and the patients were asked about prior admissions for detoxification and then evaluated for 28 months for readmissions. Patients with no comorbid diagnoses had the fewest lifetime admissions. Agoraphobia/panic disorder predicted readmission (odds ratio [OR], 5.8) for those with less than two prior admissions. For those with more than three prior admissions, readmissions were primarily related to polysubstance abuse. The development of a revolving-door career was rare (6%) among those with less than four prior admissions. Among others (27%), it was primarily predicted by polysubstance abuse. Thus, early recognition and treatment of anxiety disorders among substance abusers might prevent further readmissions.