Dual Diagnosis and Chronology of Illness in Treatment-Seeking Italian Patients Dependent on Heroin

Abstract

Although there are studies describing the prevalence of patients with drug addiction and dual diagnosis, there is a paucity of data regarding the progression from psychiatric disorders to drug addiction or vice versa. A total of 1,090 patients dependent on heroin were interviewed to examine the presence of dual diagnosis and the progression from psychiatric disorders to drug dependence or vice versa. A total of 574 patients met the criteria for a dual diagnosis. A total of 362 patients progressed from substance abuse disorders to psychiatric disorders (SUD-PR) and 144 patients progressed from psychiatric disorders to drug addiction (PSY-PR). SUD-PR patients are more frequently affected by mood disorders. PSY-PR patients were more frequently diagnosed as psychotic or affected by anxiety disorders. The authors' findings suggest that the self-medication theory of dual diagnosis was relevant only for those with existing diagnoses of schizophrenia or anxiety disorders. When treating patients with a dual diagnosis, clinicians should ensure that the same attention is given to the treatment of drug dependence as it is to the treatment of comorbid psychiatric conditions.

Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study

“…However, a high prevalence of psychiatric comorbidities, especially depressive, anxiety, and personality disorders, in OD population, is well established (Haro et al, 2004;Roncero et al, 2012;Strain et al, 2002;Wu et al, 2013). The presence of previous mental disorders has been shown to be a predictor of incident substance use/dependence (Katz et al, 2013;Maremmani et al, 2011a;Reidy et al, 2014). However, substance use may also be cause of inducing psychiatric disorders, such as stimulant-or drug-induced psychoses and substanceinduced mood disorders, as well as substance-induced anxiety conditions (Maremmani et al, 2011a;Schuckit, 2006).…”

Factores de riesgo de recaída en pacientes drogodependientes tras desintoxicación hospitalaria

“…El resultado del presente trabajo es coherente con que la adicción a heroína se ha considerado de mayor gravedad, debido a la problemática social, familiar y a las enfermedades médicas (sobre todo infecciosas) y psiquiátricas a las que se asocia (Maremmani et al, 2011;Sánchez-Hervás et al, 2010). Maremmani y cols.…”

Old Borders and New Paths of Dual Diagnosis

“…This misusing attitude perhaps was partially justified by the fact that the diagnosis of chronic intoxication from substances was often limited to the period of active use, possibly extended over a following trail of socalled prolonged withdrawal. The follow-up of drug addicts and alcoholics through the decades, and between relapses has shed brighter light on the issue of persistent psychiatric damage after detoxification, and suggested that the drug-induced syndromes may outlive the endurance of drug-using habits, following an autonomous course such as spontaneous syndromes would do [2] .…”