Clinical Outcomes From a 10-Week Follow-Up Psychoeducational Program for Dual Diagnosis

ABSTRACT

Background: Dual diagnosis covers a broad spectrum of mental health and substance misuse conditions occurring concurrently (NICE, 2016). Its manifestation is complex and, as such, the disorder is recognized as influencing adherence to prescribed medication and service engagement and has a worse prognosis than substance use and mental health conditions occurring independently. Aims: To determine the effectiveness of psychoeducational group therapy in a sample of dual diagnosis patients. Methods: Patients who met the Diagnostic and Statistical Manual of Mental Disorders-IV Axis 1 criteria for serious mental illness and current substance misuse were approached to take part in a psychoeducational program. Those who consented were assessed at baseline and end point using measures of psychiatric syptomatology, psychological well-being, and substance use patterns with the following scales: the Brief Psychiatric Rating Scale, the Hospital Anxiety and Depression Scale, the Maudsley Addiction Profile, and the Warwick-Edinburgh Mental Wellbeing Scale. Results: Fifty-one patients completed the program, while 29 dropped out after initial assessment. Between baseline and follow-up, there was a decline in the number of participants using alcohol, cannabis, cocaine, amphetamine, illicit benzodiazepines and methadone. However, the number of participants using heroin remained constant. The mean amount of substances used was not reduced over the study period except in the case of alcohol. Overall improvements in syptomatology and psychological well-being were observed. Discussion: Mental health services should focus on integrated approaches via multimodal treatment interventions that encapsulate harm reduction and educational initiatives. Despite the modest sample, the findings have emphasized the importance of a broad range of treatment approaches delivered within a unitary delivery system.

KEYWORDS:

• Dual diagnosis
• psychotherapy group
• harm reduction
• substance use disorders
• severe mental illness

Acknowledgments

Many thanks to all the patients who participated in the psychoeducational therapy program.

Disclosures

There are no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. None of the authors received any financial incentive for this study.