Department of Psychological Medicine, Faculty of Medicine, University Malaya Centre of Addiction Sciences (UMCAS), Kuala Lumpur, Malaysia.
Hospital Mesra Bukit Padang, Sabah, Malaysia.
J Dual Diagn. 2021 Jan-Mar;17(1):4-12. doi: 10.1080/15504263.2020.1854410. Epub 2020 Dec 12.
The aim of this study was to determine the prevalence of alcohol or non-alcohol substance use dual diagnosis among inpatients with severe mental illness in a psychiatric institution in Malaysia. In addition, this study aimed to determine adverse outcomes between dual diagnosis versus single diagnosis. This was a cross-sectional study conducted in the inpatient ward using the Mini-International Neuropsychiatric Interview (MINI) to establish the diagnosis of severe mental illness and to screen for alcohol or non-alcohol substance use disorder comorbidity. Outcomes and severity of different domains among severe mental illness patients were assessed using the Addiction Severity Index (ASI). Out of 152 patients who participated in this study, 51.3% ( = 78) had comorbid alcohol use disorder, and 29.6% ( = 45) had non-alcohol substance use disorder. Males with Kadazan ethnicity with severe mental illness and alcohol use disorder had a higher risk of having comorbid non-alcohol substance use disorder. Similarly, male Kadazan patients with severe mental illness and non-alcohol substance use disorder had a higher risk of having a comorbid alcohol use disorder. Dual diagnosis patients with alcohol and non-alcohol substance use disorder had higher rates of hospitalizations ( < .001 and = .001). Family and social relationships were affected among the alcohol use disorder group as shown by the higher composite score for family status (FCOMP; < .001). This group also showed more severe psychiatric status, as the composite score for psychiatric status (PCOMP) was high ( = .004). Suicidality was higher among patients with alcohol use disorder and severe mental illness ( < .001). The prevalence of severe mental illness dual diagnosis was high in this study with poorer outcomes, higher rates of admissions, and risk of suicidality. This highlights the importance of provisions for a more holistic treatment approach among patients with dual diagnosis.
本研究旨在确定马来西亚一家精神病院住院严重精神疾病患者中酒精或非酒精物质使用双重诊断的患病率。此外，本研究旨在确定双重诊断与单一诊断之间的不良结局。这是一项在住院病房进行的横断面研究，使用 Mini-International Neuropsychiatric Interview (MINI) 来确定严重精神疾病的诊断，并筛查酒精或非酒精物质使用障碍的共病。使用成瘾严重程度指数 (ASI) 评估严重精神疾病患者不同领域的结局和严重程度。在参与本研究的 152 名患者中，51.3%（ = 78）存在酒精使用障碍共病，29.6%（ = 45）存在非酒精物质使用障碍共病。患有严重精神疾病和酒精使用障碍的卡达山族男性以及患有严重精神疾病和非酒精物质使用障碍的男性卡达山族患者发生共病非酒精物质使用障碍的风险更高。同样，患有严重精神疾病和非酒精物质使用障碍双重诊断的男性卡达山族患者发生酒精使用障碍共病的风险更高。同时患有酒精和非酒精物质使用障碍的双重诊断患者住院率更高（<.001 和 =.001）。酒精使用障碍组的家庭和社会关系受到影响，表现为家庭状况综合评分（FCOMP）较高（<.001）。该组还表现出更严重的精神状态，因为精神病态综合评分（PCOMP）较高（=.004）。酒精使用障碍和严重精神疾病患者的自杀率更高（<.001）。本研究中严重精神疾病双重诊断的患病率较高，结局较差，住院率较高，自杀风险较高。这突出了为双重诊断患者提供更全面治疗方法的重要性。
