Psychiatric and substance use disorders in physical rehabilitation - disease burden, impact on rehabilitation and long-term health care needs

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Project leader

Marianne Løvstad, head of psychology, SRH, Prof. Dept of Psychology, UiO

Abstract

Many patients in need of physical rehabilitation have comorbid psychiatric and substance use disorders (SUD) at the time of acute injury/illness, and many develop mental illness throughout their recovery. Despite this, patients with comorbid mental illness are typically excluded from rehabilitation research and prone to be lost to follow-up in outcome studies, leaving evidence-based rehabilitation programs uninformed by the role of mental health issues.

Substudy 1 explores the frequency of pre- and comorbid psychiatric illness and SUD during rehabilitation, using structured diagnostic interviews. The study also explores the impact of mental illness on the rehabilitation process, i.e. functional status, length of rehabilitation stay, contacts with multi-disciplinary team, collaboration with other health care services and patient satisfaction.Substudy 1 builds upon an earlier HSØ-funded quality project and the sample consists of 131 included patients.

Substudy 2 is a follow-up study of the same cohort, were psychiatric illness and SUD is re-assessed two years after discharge from Sunnaas. The use of health care services and unmet health care needs is explored and will be compared for patients with and without comorbid mental challenges. Positive prognostic factors like social support, coping and resilience will be assessed in both sub studies and their contribution to outcomes will be explored.

The main research aim is to study the impact of psychiatric disorder/SUD on rehabilitation.

Secondary aims are to:

Identify the burden and trajectories of psychiatric disorder/SUD prior to and during rehabilitation, and two years later
Study the impact of pain, coping styles, resilience and access to social support upon the relationship between psychiatric/SUD comorbidity and rehabilitation outcomes.
Investigate prognostic factors for long-term mental illness and suicidal ideation.
Document the use of health care services and unmet health care needs two years after discharge for patients with psychiatric disorders/SUD.

Anja Schancke Sundet, clinical psychologist, SRH, PhD candidate at UiO

Solveig Hauger, senior researcher SRH, Ass. Professor UiO

Ingrid Amalia Havnes, psychiatrist, co-supervisor, Oslo University Hospital/Faculty of Medicine UiO

Nada Andelic, specialist in physical medicine and rehab, Research leader OUH/Professor, Faculty of Medicine UiO

Charles Bombardier; psychologist, scientific advisor, University of Washington

Jennie Ponsford, Professor Monash University, Melbourne, Australia, guest professor

Ethical approvals

REK: REK (2019/1284); SIKT: 875220

Funding

Stiftelsen Dam, 2 342 000 NOK

Time period

May 2022-April 2026