Dual diagnosis: On the Way to an Integrated Treatment Model?

Abstract

Introduction

Substance use disorders (SUD) with psychiatric co-morbidity (dual diagnosis) represent a challenge for both mental health and addiction networks. Dual patients present greater disorder severity and worse prognosis than those with SUD or psychiatric disorders alone. There is a lack of consensus regarding which treatment model (sequential, parallel or integrated) is the most appropriate for them. Despite integrated treatment is seen as the model of excellence, it is a standard difficult to achieve.

Objectives/Aims

To describe the presence of dual diagnosis and treatment model received in a sample recruited from a drug abuse community center in Barcelona (CAS Barceloneta).

Methods

Cross-sectional descriptive analysis of an outpatient center for SUD clinical sample regarding psychiatric co-morbidity (DSM-IV-TR criteria), social-demographic characteristics and treatment model received.

Results

In the moment of this study, a total of 574 SUD patients are attended at CAS Barceloneta. Of them, 300 (52%) present a dual diagnosis, 64% men, mean age = 48 (SD = 11.29). Thirteen percent (n = 40) of dual patients have psychotic disorder (PsyD) diagnosis and their SUD comorbidities are: alcohol-UD (12.5%, n = 5), cocaine-UD (7.5%, n = 3), cannabis-UD (15%, n = 6), opioids-UD (17.5%, n = 7) and multiple SUD (47.5%, n = 19). Half of dual patients with PsyD (n = 20) are attended in parallel in community mental health centers.

Conclusions

Our results suggest there is an important percentage of SUD patients that present psychiatric co-morbidity treated in drug abuse community centers. Parallel treatment is mainly for PsyD patients and sometimes they get lost in the gaps. We would need to develop specific dual programs to give these patients an integrated assistance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.