Comorbidity patterns in dual diagnosis across seven European sites

Background and Objectives: Psychiatric inpatients with substance use disorders are a significant public health concern due to grave consequences including increased risk of self harm, homicide as well as poor clinical outcome. The present study aims to examine and compare patterns of comorbidity (i.e. concurrent substance use disorders and severe mental illness) among psychiatric inpatients across seven European sites.Methods: 352 patients were included consecutively from psychiatric inpatients units at 7 European sites and interviewed with the Mini- International Neuropsychiatric Interview and the European version of the Addiction Severity Index questionnaires. For analysis the psychiatric diagnostic groups were organized into broader categories.Results: Concurrent alcohol use disorder and mood disorder was found to be the most prevalent comorbidity pattern (30.8%) across Europe. Alcohol or drug use disorder combined with mood disorder was most prevalent among females and in the older age group whereas mixed substance use and psychosis was more frequent among males and younger participants. Finally, differences in comorbidity patterns were found at different European sites.Conclusions: The prevalence of different comorbidity patterns varied across European clinical settings. Significant differences between comorbidity subgroups were found with regard to age and gender.</p

Bygging av Lysebotn II (Lyse Produksjon) og Lyse transformatorstasjon (Statnett). Sluttrapport miljøoppølging vannkvalitet 2016 og 2017

To større prosjekter hadde omfattende anleggsvirksomhet i Lysebotn gjennom 2016 og 2017. Nytt vannkraftverk, Lysebotn II, ble bygd av Lyse Produksjon ved entreprenør Implenia. Ny transformatorstasjon ble bygd av Statnett med grunnarbeider gjennomført av entreprenør Risa AS. Prosjektene kunne gi fare for avrenning og påvirkning av vannkvalitet i de lakse- og sjøørretførende elvene Stølsåna og Lyseåna. Vassdragene er viktige estetiske elementer for turismen i Lysebotn. Som en del av MOP- og MTA-plan for prosjektene har det blitt gjennomført automatisk overvåking av vannkvaliteten i disse vassdragene mens anleggsarbeidet har pågått. NIBIO har gjennomført denne overvåkingen etter oppdrag fra Lyse Produksjon og Statnett

Pathways through care for people with dual diagnosis in Europe: results from the treatment options for dual diagnosis user zoom instrument

Differences in care philosophies between the mental healthcare system and the substance misuse treatment system have a significant impact on treatment options for people with dual diagnosis. The aim of the study was to identify pathways through care for people with dual diagnosis in Europe using the Treatment Options for Dual Diagnosis User Zoom instrument. Declared pathways through care were categorised for 331 subjects with severe dual diagnosis recruited after admission to psychiatric wards at seven European sites and followed up over 9 months. At baseline, more than one in four subjects did not declare using either mental health or substance misuse centres or services. Mental health centres played the major role through follow-up with similar rates of declared use at all sites. By contrast, use of substance misuse treatment centres was half as frequent and varied considerably between sites. Declaring any use of substance misuse centres was generally associated with decreased overall contact with the mental healthcare system for this population of psychotic patients with comorbid substance misuse problems

Predictors of service use of patients with co-morbid mental health and substance use disorders across seven European sites

The purpose of this study was to identify factors which predict service use over time in patients with co-morbid mental health and substance use disorders (dual diagnosis). Three hundred and fifty-two patients with dual diagnosis were recruited from acute psychiatric inpatient units at seven European sites. At baseline and 9 months follow-up, socio-demographic and clinical information, as well as information concerning the use of treatment services was collected. Predictors for use of psychiatric and substance misuse services at follow-up were studied using multinomial logistic regression models. At follow-up, patients with dual diagnosis used psychiatric services significantly more than substance use services. The main predictor of service use at follow-up is influenced by the study site and not by psychopathology. More networking and signposting are needed especially for substance misuse services. Service provision and planning can improve access of vulnerable populations even when psychopathology improves

Nature, level and type of networking for individuals with dual diagnosis:a European perspective

Aim: To obtain more detailed information on service availability and appropriateness and interagency networking for individuals with dual diagnosis (DD) at seven European centres.Methods: Data was collected using two parts of the three-part Treatment of Dual Diagnosis tool in seven European centres as part of the Integrated Services Aimed at Dual Diagnosis and Optimal Recovery from Addiction (ISADORA) study between 2002 and 2005 focusing on the nature, level and type of networking for individuals with co-morbid mental health and substance misuse problems (DD). A multi-level process of qualifying networking was used.Findings: Findings show that 50-90% of the listed centres across the ISADORA sites reported some level of networking but only 30% had a joint care agreement in place or shared patient/client records with at least one other agency. Barriers and facilitators to interagency collaboration are described.Conclusion: This pan-European study highlighted the need for a more integrated and focused approach to DD service delivery.</p

Pathways through care for people with dual diagnosis in Europe: results from the treatment options for dual diagnosis user zoom instrument

Differences in care philosophies between the mental healthcare system and the substance misuse treatment system have a significant impact on treatment options for people with dual diagnosis. The aim of the study was to identify pathways through care for people with dual diagnosis in Europe using the Treatment Options for Dual Diagnosis User Zoom instrument. Declared pathways through care were categorised for 331 subjects with severe dual diagnosis recruited after admission to psychiatric wards at seven European sites and followed up over 9 months. At baseline, more than one in four subjects did not declare using either mental health or substance misuse centres or services. Mental health centres played the major role through follow-up with similar rates of declared use at all sites. By contrast, use of substance misuse treatment centres was half as frequent and varied considerably between sites. Declaring any use of substance misuse centres was generally associated with decreased overall contact with the mental healthcare system for this population of psychotic patients with comorbid substance misuse problems