The Benefit of Integrated Dual Disorders Service Utilization in the Survival of Patients in the Early Stages of Schizophrenia and Co-Occurring Substance use Disorders: a Long-Term Follow-Up Study-Global Journal of Addiction & Rehabilitation Medicine-Juniper Publishers

JUNIPER PUBLISHERS-Global Journal of Addiction & Rehabilitation Medicine

The Benefit of Integrated Dual Disorders Service Utilization in the Survival of Patients in the Early Stages of Schizophrenia and Co-Occurring Substance use Disorders: a Long-Term Follow-Up Study

Authored by Gimelfarb Yuri*

Little is known about the impact of integrated dual disorders service (based on social health insurance) utilization by population of dual diagnosis (severe mental illness and co-occurring substance use disorders), in the early stages of illness, on long-term survival. To determine the benefit of integrated dual disorders services utilization on long-term survival of these patients in the early stages of schizophrenia and co-occurring substance use disorders. The medical records of patients admitted to the Integrated Dual Disorders Treatment Ward (IDDTW) from January 1, 2002 to December 31, 2006 were assessed. Psychiatric diagnoses had been established according to the International Classification of Diseases and Health related Problems-10,h edition. The Kaplan-Meier Survival Analysis was used to estimate the cumula-tive survival rates in all the subpopulations, and the risk of all-cause mortality was as-sessed by Cox proportional-hazards regression models, with and without time-dependent covariates. During the 10.8-year median follow-up of 275 patients (of them 239 (86.9%) males), 63 (22.9%) patients died. In a time- dependent adjusted regression models, more than one year of cumulative length of stay (HR=2.48; 95% CI 1.42 to 4.34; p<.0001) and more than 2 admissions(HR=1.90; 95% CI 1.02 to 3.54; p<.001) in standard psychiatric inpatient services before the 1st admission in integrated dual disorders treatment ward were significant predictors of higher all-cause mortality. In order to facilitate accessible and available care, and to increase the long-term survival rates for these patients, the development and expansion of licensed integrated dual disorders inpatient services is recommended.

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