Changing Perspective in Dual Disorders: Substance Use, Personality Disorder, and Psychosis

Abstract

Introduction

Dual disorders constitute a clinical entity with increasing current prevalence (Köck et al. Front Psychiatry 2022; 24 13). There is frequent comorbidity between psychotic spectrum disorders and substance use disorders, which hinders both psychopathological stability and the approach to addictive behaviors (Fleury et al. Adm Policy Ment Health 2022; 20).

Objectives

The aim of this study is to describe the clinical and sociodemographic characteristics of the consumption pattern of patients diagnosed with psychosis in outpatient follow-up.

Methods

A cross-sectional study was designed with 42 users treated at the mental health center between 2019 and 2021, aged between 18 and 65 years, who had consumed alcohol, cannabis, and/or stimulants (amphetamines or cocaine), with a diagnosis of a comorbid psychotic spectrum disorder for over 3 years. A descriptive analysis of the prevalence of consumption of each predominant substance was carried out, as well as the sociodemographic and clinical characteristics were collected through a semi-structured interview. Statistical analyzes were performed using SPSS v23.0 (significance p<0.05).

Results

The predominant user profile was a man (85.7%), with a mean age of around 29 years, single (83.3%), with family support (52.4%), resident in rural areas (92.8%), with unqualified employment (57.1%) and primary studies (60%). Cannabis was the predominant substance (80.9%), followed by amphetamines (71.4%), with polydrug use of both in 78.6% of cases. A significant association was found between this combined use of substances, the relapse rate and the presence of comorbid personality disorder.

Conclusions

The paradigm of substance use in psychotic disorders has evolved towards comorbidity with polydrug use and confluence with personality disorders.

Disclosure of Interest

None Declared