Mental Disorders, Addictions Related To Long Hospitalization Days That Require Double Diagnosis in Moldova

Tarabeih Mahdi¹*, Riad Abu Rakia¹ and Victoria Gonta²

Received: May 14, 2018;   Published: May 30, 2018

DOI: 10.26717/BJSTR.2018.05.001140

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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.

Keywords: Dual Diagnosis; Drug Addiction; Psychiatric unit; Drug addiction centre; Treatment; Therapy; Psychiatric disorder

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