Unrecognised dual diagnosis - A risk factor for dropout of addiction treatment

Schulte, S. J., Meier, P. S. , Stirling, J. and Berry, M. (2010) Unrecognised dual diagnosis - A risk factor for dropout of addiction treatment. Mental Health and Substance Use: Dual Diagnosis, 3(2), pp. 94-109. (doi: 10.1080/17523281003705199)

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Abstract

Background: While many studies have examined the prevalence of concurrent substance misuse and mental health problems across different treatment populations, we know little as to what extent such co-morbidity is identified in routine clinical practice. However, literature in the field has emphasised the importance of recognising co-morbidity early to avoid adverse treatment outcomes. Aims: To determine: (1) the degree to which co-morbidity is recognised and addressed in outpatient addiction services; and (2) whether unaddressed co-morbidity increases the risk of dropout. Method: Clients (n = 176) starting treatment at six UK-based drug and/or alcohol services and their 46 practitioners were followed for 3 months. Multiple assessments were carried out in order to obtain information about clients' mental health, 90-day retention rates, treatment perceptions and practitioners' expertise and training levels in the co-morbidity field. Services' assessment protocols and in-treatment case notes for each client were examined. Results: Of 124 (71%) clients screening positive for mental health problems, services recognised co-morbidity in only 54%, and addressed it in 23%. Clients whose co-morbidity was not addressed were significantly less likely to be retained at 90 days (HR = 0.296, p < 0.005). Conclusions: Improving assessment and care planning procedures is important because of a link between unaddressed co-morbidity and dropout.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Meier, Professor Petra
Authors: Schulte, S. J., Meier, P. S., Stirling, J., and Berry, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Mental Health and Substance Use: Dual Diagnosis
Publisher:Taylor & Francis
ISSN:1752-3281
ISSN (Online):1752-3273
Published Online:04 May 2010
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