Abstract

Objective

The aim of this study was to determine the prevalence of alcohol or non-alcohol substance use dual diagnosis among inpatients with severe mental illness in a psychiatric institution in Malaysia. In addition, this study aimed to determine adverse outcomes between dual diagnosis versus single diagnosis. Methods: This was a cross-sectional study conducted in the inpatient ward using the Mini-International Neuropsychiatric Interview (MINI) to establish the diagnosis of severe mental illness and to screen for alcohol or non-alcohol substance use disorder comorbidity. Outcomes and severity of different domains among severe mental illness patients were assessed using the Addiction Severity Index (ASI). Results: Out of 152 patients who participated in this study, 51.3% (n = 78) had comorbid alcohol use disorder, and 29.6% (n = 45) had non-alcohol substance use disorder. Males with Kadazan ethnicity with severe mental illness and alcohol use disorder had a higher risk of having comorbid non-alcohol substance use disorder. Similarly, male Kadazan patients with severe mental illness and non-alcohol substance use disorder had a higher risk of having a comorbid alcohol use disorder. Dual diagnosis patients with alcohol and non-alcohol substance use disorder had higher rates of hospitalizations (p < .001 and p = .001). Family and social relationships were affected among the alcohol use disorder group as shown by the higher composite score for family status (FCOMP; p < .001). This group also showed more severe psychiatric status, as the composite score for psychiatric status (PCOMP) was high (p = .004). Suicidality was higher among patients with alcohol use disorder and severe mental illness (p < .001). Conclusions: The prevalence of severe mental illness dual diagnosis was high in this study with poorer outcomes, higher rates of admissions, and risk of suicidality. This highlights the importance of provisions for a more holistic treatment approach among patients with dual diagnosis.

中文翻译：

---

马来西亚精神病院住院患者严重精神疾病双重诊断的患病率

摘要

客观的

本研究的目的是确定马来西亚精神病院患有严重精神疾病的住院患者中酒精或非酒精物质使用双重诊断的流行率。此外，本研究旨在确定双重诊断与单一诊断之间的不良结果。方法：这是一项在住院病房进行的横断面研究，使用迷你国际神经精神病学访谈 (MINI) 来确定严重精神疾病的诊断并筛查酒精或非酒精物质使用障碍合并症。使用成瘾严重程度指数（ASI）评估严重精神疾病患者不同领域的结果和严重程度。结果：在参加本研究的 152 名患者中，51.3%（n = 78) 有共病酒精使用障碍，29.6% ( n  = 45) 有非酒精物质使用障碍。患有严重精神疾病和酒精使用障碍的卡达山族男性患有共病非酒精物质使用障碍的风险更高。同样，患有严重精神疾病和非酒精物质使用障碍的男性 Kadazan 患者患有共病酒精使用障碍的风险更高。患有酒精和非酒精物质使用障碍的双重诊断患者住院率较高（p < .001 和p = .001）。家庭和社会关系在酒精使用障碍组中受到影响，如家庭状况综合得分较高（FCOMP；p< .001）。该组还表现出更严重的精神状况，因为精神状况综合评分 (PCOMP) 较高 ( p = .004)。酒精使用障碍和严重精神疾病患者的自杀倾向更高 ( p < .001)。结论：本研究中严重精神疾病双重诊断的患病率较高，预后较差，入院率较高，有自杀风险。这凸显了为双重诊断患者提供更全面治疗方法的重要性。