Prevalence and predictors of substance abuse among patients with depressive and anxiety disorders: a cross-sectional study at a tertiary care hospital in Udaipur

Background: Substance abuse is a serious public health concern among individuals with psychiatric disorders, particularly anxiety and depression. However, data on its prevalence and association with symptom severity in Indian patients remain limited. This study aimed to determine the prevalence of substance abuse among patients with anxiety and depressive disorders and to evaluate its association with symptom severity. Methods: A cross-sectional study was conducted on 162 participants diagnosed with anxiety or depressive disorders. Data were collected on socio-demographic factors, psychiatric diagnosis, and substance use through standardized tools and urine drug screening. Severity of disorders was assessed using standard clinical rating scales. Symptom severity was evaluated using the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). Results: The majority of participants were male 119 (73.5%) and belonged primarily to the upper lower socio-economic class 68 (42.0%). Benzodiazepines 19 (11.7%) were the most frequently found substance, followed by tricyclic antidepressants 13 (8.0%) and Alcohol 8 (4.9%). Substance abuse prevalence was higher among participants with profound depression 11 out of 19 (57.9%) and among those participants with moderate anxiety 15 out of 48 (31.3%). No statistically significant difference was observed in overall substance abuse prevalence between depressive disorders 33/98 (33.7%) and anxiety disorders 18/64 (28.1%) (p=0.457). Conclusions: Substance abuse is common among patients with anxiety and depressive disorders, particularly in severe depressive depression. It is essential to address comorbid substance use in psychiatric populations through early detection and integrated management strategies.