Behavioral and Psychosocial Predictors of Treatment Response in Emergency Psychiatric Admissions for Substance Use Disorders in a Socioeconomically Vulnerable Region of Southeastern Romania: A Five-Year Retrospective Study.

Substance use disorders (SUDs) represent a major psychiatric and public health burden. Although integrated biopsychosocial approaches combining pharmacotherapy with psychosocial and behavioral interventions are recommended by international guidelines, real-world evidence on their effectiveness in acute emergency settings remains scarce, particularly in Eastern European healthcare contexts. This single-center, retrospective, observational study examined behavioral and psychosocial predictors of clinical response and compared an integrated therapeutic strategy (pharmacotherapy combined with psychosocial and behavioral interventions) with pharmacotherapy alone among all emergency psychiatric admissions for SUDs (ICD-10 F10-F19) at the Clinical Psychiatric Hospital "Elisabeta Doamna," Galați, Romania, between January 2020 and December 2024 (N = 331; census sampling). The primary outcome was clinical status at discharge (improved/stationary/worsened). Patients receiving the integrated strategy showed a significantly higher improvement rate at discharge than those receiving pharmacotherapy alone (98.3% vs. 76.3%; OR = 17.88; 95% CI: 5.62-56.91;