Dualdiagnosis"refers to patientswho sufferfroma substance disorder with a coexistingmentaldisorder. In Switzerland. there was a nationwidelackof medicaland ps)'Chosocial care for this increasing group of patients. A Unit at the Ps)'Chiatric Services of the University of Berne was opened 4 years ago whereinpatient treatmentconsidered both disorders and acts as a transit betweencrisisintervention units and rehabilitation programmes. Researchconcentrateson the development,descriptionand evaluationof inpatient treatment. A comparisonbetweenthe assessments at the beginning and after one year of treatment demonstratedthat psychopathology (thinking disturbance,anxiousdepressionand hostility/suspiciousness) decreased. housingand subsistenceimprovedbut substance abusedid not change. Onlypatientswho frequently took substances before treatmentconsumedlessor no substances at follow-up. During treatment, schizophrenics with polysubstance abusewere ableto learn better, and onsumeno or less substances than patientswithother dual diagnoses(e.g., personalitydisorders withalcoholdependency) but they could not stabilize and genera1ize their behavioural changein their everydaylives. The results are discussed concerning the impactfor. inpatienttreatmentfor patients suffering fromdual diagnosis.
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