Comorbid Addiction and Major Mental Illness in Europe: A Narrative Review

ABSTRACT

Background: Most evidence about comorbid addiction and major mental illness comes from the USA, since this literature remains relatively limited in many European countries. The purpose of this review was to examine prevalence, policies, and treatment systems of comorbid substance misuse and psychotic illness in Europe, illustrating differences and similarities with US findings. Methods: Based on computerized main databases searches, a narrative review was performed. Results: The availability of substances but also the social contexts in terms of individual and local issues are factors likely to explain different dual diagnosis prevalence rates in Europe as compared with the USA. Conclusions: Integrated models implemented following US example might perform differently within the context of well-established European Union (EU) community mental health services. Such programs would require additional resources and radical redesign of service delivery systems.

Keywords:

• Dual diagnosis
• Europe
• USA

ACKNOWLEDGMENTS

We thank João Matias, scientific assistant, Data Management and Statistical Support Team, Prevalence, Consequences and Data Management Unit, at European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). An earlier version of this review came from a presentation at the symposium “An International Perspective on Combined Addiction and Mental Illness,” co-sponsored by the International Society of Addiction Medicine (ISAM) and the National Institute on Drug Abuse (NIDA), at the American Society of Addiction Medicine 43rd Medical-Scientific Conference, Atlanta, April 19–22, 2012.

AUTHOR CONTRIBUTIONS

All authors made substantial contributions to the intellectual content of the paper. All authors gave final approval of the submitted manuscript.