Weaver T, Madden P, Charles V, Stimson G, Renton A, Tyrer P, Barnes T, Bench C, Middleton H, Wright N, Paterson S, Shanahan W, Seivewright N, Ford C
Centre for Research on Drugs and Health Behaviour/Department of Social Science and Medicine, Imperial College London, UK.
Br J Psychiatry. 2003 Oct;183:304-13. doi: 10.1192/bjp.183.4.304.
Improved management of mental illness and substance misuse comorbidity is a National Health Service priority, but little is known about its prevalence and current management.
To measure the prevalence of comorbidity among patients of community mental health teams (CMHTs) and substance misuse services, and to assess the potential for joint management.
Cross-sectional prevalence survey in four urban UK centres.
Of CMHT patients, 44% (95% CI 38.1-49.9) reported past-year problem drug use and/or harmful alcohol use; 75% (95% CI 68.2-80.2) of drug service and 85% of alcohol service patients (95% CI 74.2-93.1) had a past-year psychiatric disorder. Most comorbidity patients appear ineligible for cross-referral between services. Large proportions are not identified by services and receive no specialist intervention.
Comorbidity is highly prevalent in CMHT, drug and alcohol treatment populations, but may be difficult to manage by cross-referral psychiatric and substance misuse services as currently configured and resourced.
改善精神疾病与药物滥用共病的管理是英国国家医疗服务体系的一项优先任务，但对于其患病率及当前管理情况知之甚少。
测量社区精神卫生团队（CMHT）和药物滥用服务机构患者中共病的患病率，并评估联合管理的可能性。
在英国四个城市中心开展横断面患病率调查。
CMHT患者中，44%（95%置信区间38.1 - 49.9）报告过去一年存在问题药物使用和/或有害酒精使用情况；药物服务机构患者中有75%（95%置信区间68.2 - 80.2）以及酒精服务机构患者中有85%（95%置信区间74.2 - 93.1）在过去一年患有精神疾病。大多数共病患者似乎不符合服务间交叉转诊的条件。很大一部分患者未被服务机构识别，也未接受专科干预。
共病在CMHT、药物和酒精治疗人群中极为普遍，但按照目前的配置和资源情况，通过精神科与药物滥用服务间的交叉转诊可能难以进行管理。
