Examining Profiles and Treatment Outcomes in Dual Diagnosis: Comparison of Coordinated Treatment With Mental Health Services Versus Addiction Center Alone. A Real-World Data Analysis

Abstract

Objective

The aim of this work was to examine the profile and treatment outcomes of patients with dual pathology depending on whether the patients were attending addiction centers or are being treated in a coordinated model by mental health services.

Methods

Data from 7225 dual diagnosis patients were used, of whom 2417 (33.5%) received treatment in the mental health coordinated modality. Clinical information was taken from the patients’ electronic health record.

Results

Differences were found in patients’ sociodemographic and comorbidity profiles according to treatment modality. In general, coordinated care yielded favorable outcomes (higher attendance and lower dropout rates but no differences in retention). The logistic regression analysis identified predictors of patient profiles in coordinated care, emphasizing having a severe mental health disorder (OR = 3.878, 95% CI [3.443, 4.368]; p = .000), being referred by social/health services, or having retired status. Main differences were observed according to the comorbid diagnosis presented, particularly in cases in which the patient had impulse control, hyperkinetic, or cluster C personality disorder.

Conclusions

While therapeutic outcomes are influenced by associated comorbidities, the disorders prognosis can be favorable with appropriate treatment. Furthermore, analysis of differences according to treatment modality allows for predicting the type of patient who will receive a particular service, which enables the development of tailored treatments.

Keywords:

• Dual diagnosis
• real-world data
• substance use disorder
• therapeutic outcomes
• coordinated treatment

Acknowledgments

This study was made possible by the transfer of data by the Department of Equality, Social Policies and Conciliation of the Junta de Andalucía.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the grant “COMPARA: Comorbilidad Psiquiátrica en Adicciones y Resultados en Andalucía. Modelización a través de Big Data”, project P20_00735 on Andalusian Research, Development and Innovation Plan, provided by Fondo Europeo de Desarrollo Regional (EU) and Junta de Andalucía (Spain).