Substance Use Disorders and Comorbid Mental Disorders in First-Time Admitted Patients from a Catchment Area

Abstract

Aim: To describe lifetime mental disorders in patients with substance use disorders (SUD) admitted for the first time to specialized treatment for psychiatric or addiction problems from a catchment area. Methods: Special efforts were made to include all eligible patients and secure completion of thorough assessments, including the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) and the Structured Clinical Interview for DSM-IV axis II personality disorders (SCID-II). The strength of this study lies in its rigorous patient recruitment and assessment methods. Results: Of 61 patients, 53 had alcohol use disorder (AUD). Of these, 28 had AUD only, and 25 had an additional drug use disorder (DUD). 89% had comorbid axis I (85%) or axis II (46%) disorders. The most prevalent axis I disorders were major depressive disorder (71%), social phobia (31%) and posttraumatic stress disorder (18%). Among those with comorbid psychiatric disorders (n = 54), 25 (41% of the sample) had disorders considered to be independent of their substance use only, 4 patients (7%) had substance-induced disorders only, and 23 patients (38%) had both independent and substance-induced disorders. Conclusion: Comorbid mental disorders were remarkably prevalent in these SUD patients who were admitted for the first time.

Özel bir bağımlılık merkezinde yatarak tedavi gören hastalarda psikiyatrik eş tanının bağımlılığın seyri ile ilişkisi

“…The Axis II comorbidity rates found for substance use disorder patients in this study are consistent with the literature (22,23). Of the Axis II diagnoses accompanying substance use disorder, those of cluster B personality disorders are most common.…”

“…Craig and Dibuono (21) determined the presence of any Axis I or Axis II psychiatric comorbidities in 80.0% of patients referred for substance detoxification. Langas et al (22) reported Axis I comorbidity in 85.0% and Axis II comorbidity in 49.0% of patients presenting for treatment of substance use disorder.…”

“…Nocon et al (23) reported that among patients presenting for substance detoxification therapy, during their lifetime 40.9% had a diagnosis of any kind of mood disorder, 6.0% a diagnosis of psychotic disorder, and 16.5% any kind of anxiety disorder. Langas et al (22) reported that among patients with substance use disorder, 75.0% showed comorbidity with any mood disorder, 50.0% with any anxiety disorder, and 5.0% with any psychotic disorder. The present study shows comorbidity rates for mood disorders and depressive disorders consistent with the literature, while anxiety disorder was found at a lower rate and psychotic disorder more frequently.…”

Comorbid mental disorders among clients in addiction treatment: The costs of care

“…As well, a full psychiatric screening and assessment would have been preferable to self-reported mental disorder diagnoses, which are subject to recall biases and contingent on prior mental health service use. The prevalence of mental disorders in this treatment population is indeed notably lower than that observed when a structured psychiatric assessment is used (Langås et al, 2012).…”

“…Particularly in clinical contexts, evidence suggests that the majority of clients have a history of both types of disorders (Adamson, Todd, Sellman, Huriwai, & Porter, 2006;Castel, Rush, Urbanoski, & Toneatto, 2006;Chan, Dennis, & Funk, 2008;Langås, Malt, & Opjordsmoen, 2012). In addition to presenting with a more complex array of problems, clients with co-occurring disorders are at risk of poorer substance-related and psychological outcomes following treatment (Baker et al,Despite the clear policy and clinical implications, there is a dearth of research examining the implications of cooccurring disorders for the course and costs of addiction treatment.…”