Comorbidity and outcome in dual diagnosis patients – characteristics of 228 inpatients

Abstract

Little is known about the outcome characteristics of integrated treatment programs for patients with mental health and substance use problems. The aim ofthe present study is to describe an inpatient-population with comorbid mentalhealth disorders and substance use disorders with regard to diagnostic comorbidity and outcome. Routine outcome data on a consecutive sample of 228 patients admitted to an integrated Dual Diagnosis program in the Netherlands are presented. These data include the change in global assessment of functioning (GAF) scores between admission and discharge, remission of substance abuse, specific associations between mental health diagnoses and substance use diagnoses and whether patients completed their inpatient-treatment. Logistic regression analysis showed that the presence of a borderline personality disorder and/or cocaine dependence on admission predicted a worse outcome. There is a lack of evidence-based interventions for dual disorder patients with a borderline personality disorder and cocaine dependence. Specific expertise is needed to treat this subgroup of patients successfully.

Keywords:

• comorbidity
• borderline personality disorder
• substance use disorder
• residential treatment
• outcome

Acknowledgements

We thank D. Willems for help with the statistical analysis. E. Franzek gave helpful comments on the earlier version of this article.