Arias Francisco, Szerman Nestor, Vega Pablo, Mesias Beatriz, Basurte Ignacio, Morant Consuelo, Ochoa Enriqueta, Poyo Félix, Babín Francisco
Servicio de Psiquiatría, Hospital Doce de Octubre, Madrid, Spain.
Adicciones. 2013;25(2):118-27.
The objective was to quantify the prevalence of dual diagnosis and to evaluate the characteristics of these patients from community mental health and substance misuse services in Madrid. The sample consisted of 837 outpatients from Madrid, 208 from mental health services and 629 from substance misuse services. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate disorders from axis I and II. It was considered that 517 (61.8%) patients had dual pathology (current diagnoses of axis I or II disorders and an addictive disorder): 36,1% in mental health services and 70,3% in substance misuse services. There were fewer males amongst the dual patients and it was also found that they had a worse employment situation, along with higher figures of alcohol and cannabis dependence than addicts without dual diagnoses (n=194). When comparing them with patients with mental disorder diagnoses only, excluding substance use disorder (n=126), there were differences in all socio-demographic characteristics analyzed, and dual patients were associated with diagnoses of bipolar disorder, agoraphobia, generalized anxiety disorder, post-traumatic stress disorder, and had more suicide risk and different personality disorders. Thus, dual pathology is higher in patients who are in treatment and have differential characteristics (higher suicide risk, worse employment situation) that suggest greater severity that could be of help in the planning of care resource policies for these patients.
目的是量化双重诊断的患病率，并评估马德里社区心理健康和药物滥用服务中这些患者的特征。样本包括来自马德里的837名门诊患者，其中208名来自心理健康服务机构，629名来自药物滥用服务机构。我们使用迷你国际神经精神访谈（MINI）和人格障碍问卷（PDQ4+）来评估轴I和轴II的疾病。据认为，517名（61.8%）患者患有双重病理（目前轴I或轴II疾病诊断和成瘾性疾病）：心理健康服务机构中为36.1%，药物滥用服务机构中为70.3%。双重诊断患者中的男性较少，还发现他们的就业状况较差，与没有双重诊断的成瘾者（n=194）相比，酒精和大麻依赖率更高。当将他们与仅患有精神障碍诊断（不包括物质使用障碍，n=126）的患者进行比较时，在所有分析的社会人口学特征方面存在差异，双重诊断患者与双相情感障碍、广场恐惧症、广泛性焦虑障碍、创伤后应激障碍的诊断相关，并且有更高的自杀风险和不同的人格障碍。因此，双重病理在接受治疗的患者中更为常见，并且具有不同的特征（更高的自杀风险、更差的就业状况），这表明病情更严重，这可能有助于为这些患者制定护理资源政策。
