Dual-Diagnosis Empirical and Developmental-Humanistic Approaches

Dual Diagnosis in Elders Discharged From a Psychiatric Hospital

“…While the prevalence rates for young and middle-aged dually diagnosed populations in psychiatric facilities are 34.1% for alcohol disorders and 16.1% for other drug abuse disorders (Regier et al, 1990), almost three-fourths (71%) of our sample of dually diagnosed hospitalized elders abused alcohol and 29% abused both alcohol and other substances. However, while the older dually diagnosed patients in our sample abused prescription drugs such as sedative/hypnotics and antianxiety medications, younger populations have been found to use illicit drugs such as marijuana, cocaine, barbiturates, opium, psychostimulants, hallucinogens and inhalants (Lehman et al, 1993;McKenna and Paredes, 1992).…”

“…A psychiatric disorder together with alcohol or drug addiction is referred to as a`dual diagnosis' (McKenna and Paredes, 1992;Turnbull and Roszell, 1993;Riley, 1994). Findings from the National Institute of Mental Health's Epidemiologic Catchment Area Study (ECA) of 20 291 community-residing subjects suggest that the cooccurrence of substance abuse and mental disorders happens more frequently than chance would predict.…”

“…Lifetime prevalence rates of substance abuse among the mentally ill may be as high as 87% for individuals with antisocial personality disorders, 56% for bipolar disorders, 47% for schizophrenics and 32% for depressive disorders (Regier et al, 1990). High rates of substance abuse have been found among inpatient psychiatric populations (Regier et al, 1990;McKenna and Paredes, 1992), the mentally retarded (Gabriel, 1994;Reiss, 1990;Matson and Barrett, 1992), the deinstitutionalized homeless (Caton et al, 1994;Kahn et al, 1992) and psychiatric patients who present to emergency departments (Lieberman and Baker, 1985;Szuster, 1990;Sanguineti and Samuel, 1993) and primary care settings (Crum and Ford, 1994). Lifetime comorbidity rates for mental illness and substance abuse in prison populations have been found to be as high as 94% (Abram and Teplin, 1991;Regier et al, 1990).…”

Follow-up studies of schizophrenia I: Natural history and non-psychopathological predictors of outcome

“…The prevalence of drug and alcohol use among psychotic patients is high in various countries and settings (l 5-50% of patients) (Bland et al, 1987;McKenna and Paredes, 1992;Strakowski et al, 1993); therefore even small effects that such use may have on subsequent course is of great public health importance. Drug and alcohol use among psychotic patients is more common in men than in women (Haas et al, 1990;McGlashan and Bardenstein, 1990), so that the effect of sex must be controlled for in examining associations with course and outcome.…”