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Minerva Psichiatrica 2006 September;47(3):231-42

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: Italian

Psychiatric comorbidity in substance use disorders. Epidemiolgy, psychopathology, screening and assessment: a narrative review

Scioli R. 1, Restani L. 2, Clerici M. 3, Carrà G. 4

1 Azienda Ospedaliera della Provincia di Pavia 2 Istituto S. Cuore di Gesù Fatebenefratelli San Colombano al Lambro, Milano 3 Dipartimento di Medicina, Chirurgia e Odontoiatria - Clinica Psichiatrica Università degli Studi di Milano, Milano 4 Department of Mental Health Sciences Royal Free and University College Medical School, UK


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Aim. Dual Diagnosis issues are increasingly affecting Italian mental health services. Epidemiological surveys show high, though variable, comorbidity rates. It is paramount focussing main epidemiological, assessment and diagnostic features to set up adequate and effective services for Dual Diagnosis.
Methods. A literature search was carried out using the Medline and PsychInfo databases (1970-July 2004).
Results. Because of diagnostic issues screening and assessment questionnaires are recommended to detect populations at risk and evaluating psychosocial functioning. Both mental health and addiction services’ clients should be targeted by such procedures. Personality disorders, mainly antisocial and borderline ones, are frequently diagnosed, as well as Mood Disorders with significant suicidal risk. Substance use comorbidity affects between 47% and 58% among psychotic patients.
Conclusions. Treatment outcomes seem affected by: a) patient’s motivation; b) team’s optimum staffing and training, c) evidence based approach to program models and chosen therapeutic options.

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