TY - JOUR
T1 - Perceived advantages and disadvantages of substance use in a dual diagnosis population with severe mental disorders and severe substance use disorder. Considering the self-medication hypothesis
AU - Düring, Signe Wegmann
AU - Austin, Stephen Fitzgerald
AU - Mårtensson, Solvej
AU - Johansen, Katrine Schepelern
N1 - Publisher Copyright:
© 2024 The Nordic Psychiatric Association.
PY - 2024
Y1 - 2024
N2 - Aim: Based on a large cohort of dual diagnosis patients, the aim of this study was to quantify the patient-perceived problems and advantages of their substance use and relate the quantity of problems to the substance type and psychiatric diagnosis. Material: Data comes from a naturalistic cohort admitted to an in-patient facility in Denmark specialized in integrated dual diagnosis treatment. We included 1076 patients at their first admission to the facility from 2010 to 2017. Participants completed 607 DrugCheck and 130 DUDIT-E questionnaires. Method: we analyzed the questionnaires and included admission diagnosis by use of t-test and ANOVA to depict the patterns in substance use in relation to psychiatric diagnosis. Results: The three most common substance related problems according to the DrugCheck questionnaire were: feeling depressed, financial problems, and losing interest in daily activities. From DUDIT-E, the highest-ranking negative substance related effects were financial ruin, deterioration of health, and problems at work. Effects on social life relationships were also evident with more than 40% of participants. The top three positive substance related effects reported were relaxation, improved sleep, and control over negative emotions. The number of problems listed varied significantly with the type of preferred substance. Patients using pain medication, sedatives, central stimulants, and alcohol reported most problems. Diagnosis did not differentiate the problems experienced. Results partially support the broad self-medication hypothesis for patients with severe mental illness, but also points out that patients are well aware of negative effects.
AB - Aim: Based on a large cohort of dual diagnosis patients, the aim of this study was to quantify the patient-perceived problems and advantages of their substance use and relate the quantity of problems to the substance type and psychiatric diagnosis. Material: Data comes from a naturalistic cohort admitted to an in-patient facility in Denmark specialized in integrated dual diagnosis treatment. We included 1076 patients at their first admission to the facility from 2010 to 2017. Participants completed 607 DrugCheck and 130 DUDIT-E questionnaires. Method: we analyzed the questionnaires and included admission diagnosis by use of t-test and ANOVA to depict the patterns in substance use in relation to psychiatric diagnosis. Results: The three most common substance related problems according to the DrugCheck questionnaire were: feeling depressed, financial problems, and losing interest in daily activities. From DUDIT-E, the highest-ranking negative substance related effects were financial ruin, deterioration of health, and problems at work. Effects on social life relationships were also evident with more than 40% of participants. The top three positive substance related effects reported were relaxation, improved sleep, and control over negative emotions. The number of problems listed varied significantly with the type of preferred substance. Patients using pain medication, sedatives, central stimulants, and alcohol reported most problems. Diagnosis did not differentiate the problems experienced. Results partially support the broad self-medication hypothesis for patients with severe mental illness, but also points out that patients are well aware of negative effects.
KW - Drugcheck Questionnaire
KW - Dual diagnosis
KW - DUDIT-E
KW - integrated treatment
KW - substance use
KW - Mental Disorders/diagnosis
KW - Comorbidity
KW - Humans
KW - Middle Aged
KW - Male
KW - Self Medication/psychology
KW - Substance-Related Disorders/psychology
KW - Denmark
KW - Female
KW - Adult
KW - Surveys and Questionnaires
KW - Diagnosis, Dual (Psychiatry)
U2 - 10.1080/08039488.2024.2318649
DO - 10.1080/08039488.2024.2318649
M3 - Journal article
C2 - 38380582
AN - SCOPUS:85186455084
SN - 0803-9488
VL - 78
SP - 281
EP - 289
JO - Nordic Journal of Psychiatry
JF - Nordic Journal of Psychiatry
IS - 4
ER -