Authors: Abubakr Elmotesim Abdulla Elamin , Adam Mohamed Saber Mohamed , Mohammed Abdullah Alhejji , Hassan Ahmad Khubrani , Sameera Gamal Moubark Mohamed , Amira Gaber Ibrahim Mostafa , Shaimaa Magdy Nassar , Amnah Mohammed Ali , Moutaz Ali Kasasbeh

Abstract

Background: Psychiatric comorbidity is common among patients with substance use disorders (SUDs) and is associated with poorer treatment outcomes. Data from inpatient rehabilitation settings in Saudi Arabia remain limited. This study estimated the prevalence, patterns, and clinical correlates of psychiatric comorbidity among inpatients with SUDs.

Methods: A retrospective cross-sectional review of inpatient records at a behavioral rehabilitation center in Riyadh covering January–December 2025 was conducted. 147 admission episodes from 135 unique patients were identified; the primary analysis used each patient’s first admission (n = 135). Descriptive statistics, chisquare tests, Spearman correlations, and multivariable logistic regression were applied.

Results: Psychiatric comorbidity was documented in 90 of 135 patients (66.7%; 95% confidence interval, 58.0%-74.5%). Among comorbid patients, psychotic disorders (30/90, 33.3%), depressive disorders (23/90, 25.6%), and anxiety disorders (17/90, 18.9%) were most frequent, and 58/90 (64.4%) presentations were recorded as substance-induced. No examined variable was independently associated with comorbidity (model p = 0.472). Psychiatric follow-up was arranged for 41 of 90 comorbid patients (45.6%). Episode-level results were similar (95/147, 64.6%).

Conclusion: Approximately two-thirds of inpatients with SUDs had a documented psychiatric comorbidity, predominantly psychotic, depressive, and anxiety presentations. Fewer than half of comorbid patients had psychiatric follow-up arranged at discharge, indicating a need to strengthen psychiatric assessment and integrated discharge planning.

Keywords: Substance use disorders, psychiatric comorbidity, dual diagnosis, inpatient rehabilitation, Saudi Arabia.