Length of hospital admission, cannabis use and associated factors in patients with bipolar disorder

Background: Psychiatric care is increasingly shifting towards de-institutionalisation and outpatient treatment, resulting in a reduction in the length of hospital admission (LOA) for patients with serious mental illness (SMI). Understanding the factors influencing LOA in patients with bipolar disorder (BD) is important for managing associated healthcare costs. Aim: The study aims to determine socio-demographic and clinical characteristics of patients with BD and to determine whether cannabis use affected LOA. Setting: Chris Hani Baragwanath Academic Hospital, South Africa. Methods: A retrospective record review of the patients admitted with BD between 01 July 2022 and 30 June 2023 was conducted. Results: The median LOA was 23 days. No significant associations were found between clinical characteristics, socio-demographic factors and LOA. Over one-third of the patients used cannabis. However, there was no association between cannabis use and LOA. Conclusion: The LOA in patients with BD was similar to that of patients with SMI in general, as reported within sub-Saharan African literature. The lack of an association between socio-demographic or clinical characteristics and LOA in the patients with BD supports existing South African literature findings. Cannabis use among patients with BD was lower than that reported in patients with SMI in South Africa. No clear association was found between cannabis use and LOA. Contribution: Preliminary data suggested an increase in cannabis use post-decriminalisation in South Africa. While there are concerns about the impact of cannabis use on the healthcare system should cannabis use increase, this study found no evidence that cannabis use increases LOA in patients with BD.