Mental Disorders, Addictions Related To Long Hospitalization Days That Require Double Diagnosis in Moldova
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 5, Issue 1
Abstract
Introduction: Dual Diagnosis is undoubtedly one of the most important and particular problems that mental health services are facing. The common problem of all patients is that is entering in Psychiatric Services due to complications from the use or abuse of legal and illegal substances and at the same time the presence of another psychiatric disorder. The Literature supports the hypothesis that psychiatric disorder and substance abuse disorder coexist more frequently than luck can predict. Aim: The aim of this study was to examine, assess and compare the characteristics and the psychopathology between patients with dual diagnosis receiving treatment for mental disorders and those receiving treatment for substance use disorders in Substance Use treatment programs in Mental Health Services of Moldova. Furthermore, this study examines the differences in psychopathology in correlation with the alcohol dependence, the duration of treatment and the number of hospital isations in relation with dual diagnosis. Methods: Three hundred patients (150 of them were dually diagnosed that were, admitted to drug addiction therapeutic and rehabilitation centers for legal and illegal substances and 150 were dually diagnosed were admitted to Psychiatric units in Mental Health Center in Moldova). The Europe ASI the AUDIT, and the PDQ4 were administered individually to each one of the participants. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. Results: Results revealed that the dually diagnosed patients that were admitted in psychiatric units had higher number of diagnosis (mhuM=3.03, duM=2.55, pvalue) higher number of hospitalization in Mental Health Services (mhuM=12.25, duM=7.73) and much more psychological problems (mhuM=63.02, duM=18.78), as well as longer prison time (mhuM=5.55, duM=2.10), compared with those that are entered in Substance Use treatment programs. The mean age of first use for men was 17.88 for psychiatric patients and 17.52 for patients that are entering in Substance Use treatment programs (pvalue=0.001). For women, the mean starting age was 17.50 in psychiatric units and 17.60 in Substance Use treatment programs (pvalue=0.01). The main substance of dependence in most cases was cannabis, followed by cocaine, in both study groups (57.5% of cannabis, 20% of cocaine in psychiatric units and 30% of cannabis, 20% of cocaine in drug Substance Use treatment Programs. 53.4% of people in Substance Use treatment programs had a family history of alcoholism, while the corresponding figure for those in psychiatric units was 46.6%, 50% of both groups had a family history of drug addiction. The patients with anti-social disorder according to the PDQ-4 questionnaire had a higher incidence of alcohol dependence than patients without anti-social disorder. The use of alcohol the last 30 days was associated with an increase in the frequency of alcohol dependency. Implications for Mental Health Nursing: Results shows that the lack of a specialized treatment centre creates a huge gap for treatment, which leads to Mental Health Services overuse and misuse, and to continuous hospitalisations and relapses, leading dual diagnosis patients to disorganisation and isolation. Mental health specialists should learn and educated in new therapeutic approaches in order to treat dually diagnosed patients holistically. The term dual diagnosis includes those individuals who experience drug addiction disorder and co-occurring psychiatric disorders. People with co-existing psychiatric disorders (Axis I or Axis II) and substance use disorder, as well as individuals who experienced both type of disorder during their lifetime is not necessarily simultaneously [1-3]. Dual diagnosis may include any class of mental dis-order that coexists with substance disorder such as post-traumatic stress disorder, anxiety disorder, bipolar disorder, schizophrenia, mania, depression, personality disorder. Usually clinical characteristics are related to the type of psychiatric disorder that is presented by the individual for example many studies have highlighted the relationship between the presence of acute psychotic syndrome and mania and the use of cannabis. The various studies carried out during these decades on population of people that are treated for substance abuse showed that around 50-75% of these individuals presented at the same time some sort of mental disorder (without necessarily being a sever psychiatric disorder) while investigations into populations of people treated for mental disorders recorded rates of 20-50% of these people with coexisting substance abuse [4] The various surveys recorded similar rates of dual disorder in individuals approaching drug treatment regimens [5-11]. Based on everything that has been mentioned above, the intense engagement of mental health specialists, researchers and clinics in recent years with the issue of dual diagnosis is reasonable. It is now common acceptance both on the part of the Mental Health Services and the staff members that there is a lack of evaluation and management of the issue, a lack of services for dually diagnosed patients, lead to a wastage of costs with ineffective provision and there are a lot that needed to be done to enable Mental Health Services to provide a rich therapeutic effect to problems of dual diagnosis and early treatment of consequent problems that affect both the individual as a unit and society as a whole. Within this framework, the need for research on this issue is important. The prospect of investigating dual diagnosis and the characteristics of people with dual diagnosis attempts to explain how this phenomenon affects the therapeutic effect, the course of the disease, the number of infections, and how is generally affects the use of mental health services [11-17]. The purpose of this research, is to explore the characteristics of dually diagnosed patients who approach the Public Mental Health Services in Moldova, examine the differences and similarities of the two group those that are entering in Substance Use Treatment Programs and those that are entering in Psychiatric Units in relation to demographic characteristics, the number of hospitalization, the number of relapses and the frequency of coexistence of these two disorders. Additionally other aims of this research is to explore the relation between the main substance use, the degree of alcohol dependence and the presence of specific mental disorder.
Authors and Affiliations
Tarabeih Mahdi, Riad Abu Rakia, Victoria Gonta
Keywords
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- EP ID EP591624
- DOI 10.26717/BJSTR.2018.05.001140
- Views 195
- Downloads 0
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