International Journal of Social Psychiatry 59(8) 757–764 © The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0020764012456803 isp.sagepub.com E CAMDEN SCHIZOPH Introduction In patients using addictive substances, physical comorbidity is a common issue. Three types of problems – drug use, comorbid mental disorders and physical illness – interact unfavourably, thus requiring comprehensive health care programmes (Phelan, Stradins & Morrison, 2001). While many studies of comorbid physical conditions among peo- ple with mental illness have focused on schizophrenia (Leucht, Burkard, Henderson, Maj & Sartorius, 2007), excess physical morbidity and mortality have also been identified in other types of mental disorder, such as mental retardation, eating disorders, affective disorders and, in par- ticular, substance use disorders (SUD) (Harris & Barraclough, 1998; Kilian, Becker, Krüger, Schmid & Frasch, 2006; Osborn, 2001). Physical illness in psychiatric inpatients: Comparison of patients with and without substance use disorders Karel Frasch, 1 Jens Ivar Larsen, 2 Joachim Cordes, 3 Bent Jacobsen, 4 Signe Olrik Wallenstein Jensen, 2 Christoph Lauber, 5 Jørgen Achton Nielsen, 6 Kenji J Tsuchiya, 7 Richard Uwakwe, 8 Povl Munk-Jørgensen, 2 Reinhold Kilian 1 and Thomas Becker 1 Abstract Background: Physical comorbidities and substance use are commonly reported in patients with mental disorders. Aim: To examine somatic comorbidity in patients with substance use disorders (SUD) compared to patients with mental disorders but no SUD. Methods: Lifetime prevalence data on mental and physical health status were collected from inpatients in 12 mental health care facilities in five different countries. Differences in somatic comorbidity were examined by means of logistic regression analysis controlling for age and gender. Results: Of 2,338 patients, 447 (19%) had a primary or secondary SUD diagnosis. In comparison to patients with other mental disorders, patients with SUD had a higher prevalence of infectious and digestive diseases but a lower prevalence of endocrine, nutritional and metabolic disorders. Patterns of physical comorbidities differed according to type of substance used (alcohol use – cardiovascular; tobacco use – respiratory, neoplasms; cannabinoid use – injuries; opioid use – infectious, digestive; benzodiazepine use – endocrine, nutritional, metabolic; stimulants – urogenital). Conclusions: SUD are related to specific somatic health risks while some of our findings point to potentially protective effects. The widespread prescription of benzodiazepines requires research on physical health effects. Early detection of SUD and their integration into programmes targeting physical comorbidity should be a priority in organizing mental health care. Keywords Substance use disorders, somatic comorbidity, physical illness, somatic health risks, psychiatric inpatients 1 Department of Psychiatry II, Ulm University, Günzburg, Germany 2 Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark 3 Department of Psychiatry and Psychotherapy, Düsseldorf University, Germany 4 Aalborg Hospital, Department of Medical Gastroenterology, Aarhus University Hospital, Aalborg, Denmark 5 University of Liverpool, UK 6 Aarhus University Hospital, Risskov, Denmark 7 Hamamatsu University School of Medicine, Hamamatsu, Japan 8 Nnamdi Azikiwe University, Nnewi Campus, Nigeria Corresponding author: Karel Frasch, Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Strasse 2, D-89312 Günzburg, Germany. Email: karel.frasch@bkh-guenzburg.de 456803ISP 59 8 10.1177/0020764012456803International Journal of Social PsychiatryFrasch et al. 2012 Article