Galanter M, Egelko S, Edwards H, Vergaray M
Division of Alcoholism and Drug Abuse, New York Medical Center, NY 10016.
Addiction. 1994 Oct;89(10):1227-35. doi: 10.1111/j.1360-0443.1994.tb03301.x.
Patients with combined general psychiatric and addictive disorders are a major public health problem in the US, and are being increasingly recognized as such world-wide. The authors describe a model treatment system for such patients in one municipal hospital in New York. It is composed of three complementary units: a locked ward, a halfway house and a day program. Treatment is based on a peer leadership approach coupled with professional treatment, and provides multiple levels of care to address the needs of respective patients. Of 464 admissions evaluated and treated, most were from disadvantaged minorities, homeless and abusers of cocaine. All were admitted with acute psychiatric or perinatal presentations, and carried Axis I diagnoses in addition to their substance abuse. Clinical experience over 6 years is reviewed, suggesting the feasibility of reorganizing general hospital psychiatric services to address the needs of the dually diagnosed.
患有一般性精神疾病和成瘾性疾病的患者是美国的一个重大公共卫生问题，并且在全球范围内也日益被视为一个问题。作者描述了纽约一家市级医院针对此类患者的一个模范治疗系统。它由三个互补单元组成：一个封闭病房、一个中途之家和一个日间项目。治疗基于同伴引领方法并结合专业治疗，提供多层次护理以满足各个患者的需求。在接受评估和治疗的464名入院患者中，大多数来自弱势少数群体、无家可归者以及可卡因滥用者。所有人入院时都伴有急性精神症状或围产期症状，除了药物滥用外还伴有轴I诊断。回顾了6年的临床经验，表明重组综合医院精神科服务以满足双重诊断患者需求的可行性。
