Analysis of the profiles of patients with dual pathology attending addiction centers, mental health centers, and a coordinated service

Abstract

La atención médica y psicológica de pacientes con patología dual es realizada por servicios de salud mental, adicciones, o coordinada. No obstante, es elección de los pacientes acudir a uno u otro servicio. Este trabajo tiene como objetivo analizar las semejanzas y diferencias de pacien- tes con patología dual que acuden a estos centros. El estudio se ha realiza- do con 170 pacientes diagnosticados de patología dual atendidos en el Ser- vicio Provincial de Drogodependencias de Huelva (SPDH) y Unidades de Salud Mental Comunitaria (USMC) de la provincia de Huelva. En el SPDH la prevalencia de pacientes con dependencia a heroína y cocaína es mayor (35.9% vs 2% en USMC y 16.4% en coordinado). En las USMC se observa una mayor prevalencia de pacientes con dependencia a cannabis (41.2% vs 9.4% en el CTA y 16.4% en coordinado). La odds ratio para pacientes con episodios hipomaníacos fue de 2.879 (p < .05) en el SPDH, y de 0.483 (p < 0.05) para episodios maníacos. Hay una mayor prevalencia de pacientes con trastornos psicóticos en las USMC en comparación con el SPDH (66% vs 37.5%). Las diferencias detectadas en los perfiles deben ser consi- deradas en la planificación asistencial de los centros que atienden a estos pacientes.

The aim of this study was to analyze and compare the profile of dual patients treated in mental health units or drug user services with pa- tients using both. The sample consisted of 170 patients diagnosed with dual pathology, re- cruited using an accidental sampling technique. Of the sample, 64 were be- ing treated at Addiction Center of Huelva (ADH), 51 at various Commu- nity of Mental Health Units (CMHU) in the province of Huelva and 55 were treated with a coordinated use of both resources. The patients were diagnosed using MINI and PID-5. A higher prevalence of patients with a cocaine and heroin dependence profile was observed in the patients treat- ed in ADH (35.9%, as opposed to 2% in CMHU and 16.4% in the coor- dinated service). For those patients treated in CMHU there was a higher prevalence of profiles related to cannabis dependence (41.2%, as opposed to 9.4% in the ADH and 16.4% in the coordinated service). The odds ra- tio for hypomanic episodes was 2.879 (p < 0.05) for patients in ADH compared with the other two services. The odds ratio observed for manic episodes was 0.483 (p < .05) in ADH patients, whilst for patients in CMHU there was a higher prevalence of comorbid psychotic disorders in comparison with those using ADH services (66% as opposed to 37.5%). The high prevalence of comorbid disorders -along with the differences in profiles identified between services- suggests the need to consider treating these patients using integrated services.