Comparisons of patients with comorbid psychiatric and substance use disorders: Implications for treatment and service delivery
Comparisons of patients with comorbid psychiatric and substance use disorders: Implications for treatment and service delivery
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DOI：
10.1176/appi.ajp.161.1.139
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发表时间：
2004-01-01
影响因子：
17.7
通讯作者：
Owen, KK
中科院分区：
文献类型：
--
作者：
Havassy, BE;Alvidrez, J;Owen, KK
目的：患有精神疾病和药物滥用障碍的患者在心理健康和药物滥用治疗系统中接受治疗，但关于共病障碍的研究很少包括跨系统的比较，关于具有共病标签但发现在不同治疗部门的患者的知识应该启发服务问题并为政策制定提供参考。不同系统之间的差异应为单独处理提供支持；相似之处应表明服务集成的价值。结果：在一项更大规模的纵向研究中，106例来自心理健康(N=106)和药物治疗(N=120)的患者在诊断、药物使用和问题严重程度方面进行了比较。使用DSM-IV诊断性访谈程序和成瘾严重程度指数获得数据。结果：组间差异不大。除了精神分裂症谱系障碍在精神健康患者(43%)中比药物治疗患者(31%)更常见外，没有诊断上的差异。虽然在接受治疗前30天内吸毒人数多于心理健康受试者，但在此期间的平均用药天数并无差异。结论：这些发现证实了戒毒服务对象中严重精神疾病和精神健康患者中严重药物问题的高患病率。两组之间只出现了很小的差异，没有一组表明需要在不同的护理系统中进行专门治疗。
Objective: individuals with co-occurring psychiatric and substance use disorders are treated in mental health and substance abuse treatment systems, yet research on comorbid disorders rarely includes comparisons across systems, Knowledge about patients who share the label "comorbid" but are found in different treatment sectors should illuminate service issues and inform policy development. Differences across systems should provide support for separate treatments; similarities should indicate the value of the integration of services. The hypothesis that there are meaningful clinical differences between patients with comorbid mental health disorders and patients in drug treatment was tested.Method: As part of a larger longitudinal study, 106 patients with comorbid illness from mental health (N=106) and drug treatment (N=120) settings were compared regarding diagnosis, drug use, and problem severity. Data were obtained by using the Diagnostic Interview Schedule for DSM-IV and the Addiction Severity Index.Results: Few differences between groups emerged. There were no diagnostic differences except that schizophrenia spectrum disorders were more common among mental health (43%) than drug treatment (31%) patients. Although more drug abuse than mental health subjects reported drug use in the 30 days before treatment entry, the average number of days of drug use in this period was not different.Conclusions: These findings document the high prevalence of severe mental illness in drug treatment clients and of serious drug problems in mental health patients. Only minimal differences emerged between the groups and none that indicated need for specialized treatments in separate systems of care.