Carrà Giuseppe, Scioli Rosangela, Monti Maria Cristina, Marinoni Alessandra
Department of Mental Health Sciences, Royal Free and University College Medical School, London, United Kingdom.
Eur Addict Res. 2006;12(2):96-101. doi: 10.1159/000090429.
Mental health and addiction services have traditionally evolved separately in many European countries, with policy reflecting this. Differences in severity profiles between users of the community addiction services with comorbidities of mental illness and substance misuse and those with substance misuse only were studied using a matched case-control study design, with regard to the main substance (opiates or cocaine) patients were dependent on. Patterns of substance abuse and diagnostic features were evaluated according to the Addiction Severity Index (ASI) and DSM-IV. Mentally ill substance abusers are significantly more likely to have used amphetamines, inhalants and having been polydrug users. They are particularly impaired in medical and family/social relationships ASI composite scores, but less in drug use. Severity profiles and needs of dually diagnosed patients require assessment and treatment skills that should be provided through adequate links with mental health system.
在许多欧洲国家，心理健康服务和成瘾服务传统上是分开发展的，政策也反映了这一点。采用匹配病例对照研究设计，针对社区成瘾服务的使用者（他们同时患有精神疾病和药物滥用或仅患有药物滥用），就患者所依赖的主要物质（阿片类药物或可卡因），研究了他们之间严重程度特征的差异。根据成瘾严重程度指数（ASI）和《精神疾病诊断与统计手册》第四版（DSM-IV）对药物滥用模式和诊断特征进行了评估。患有精神疾病的药物滥用者更有可能使用过安非他命、吸入剂，并且是多药使用者。他们在医疗和家庭/社会关系ASI综合评分方面受到的损害尤为严重，但在药物使用方面受到的损害较小。双重诊断患者的严重程度特征和需求需要通过与心理健康系统的适当联系来提供评估和治疗技能。
