[LONG-TERM SURVIVAL OF DUAL DISORDERS PATIENTS AFTER MIXED CARE IN DUAL DISORDERS AND STANDARD WARDS VERSUS CARE ONLY IN DUAL DISORDERS WARD].

Background: Dual disorders (co-occurring mental illness and substance abuse disorders in the same person) are extremely common among patients receiving mental health services. Integrated treatment has been proposed as the standard of care and it describes a flexible combination of treatments from the mental health and addiction fields that are blended together in the therapy. Scientific evidence for survival of dual disorders patients (DDPs), who had integrated dual disorders inpatient care, is lacking.

Objectives: To determine the long term survival rates following integrated care (Integrated Dual Diagnosis Treatment Ward [IDDTW] only) versus mixed care (IDDTW and psychiatric wards) during the life-time of DDPs.

Methods: The charts of 333 subjects admitted to IDDTW during the period January 2002 - June 2006 were assessed at least 8 years after the first admission. Psychiatric diagnoses have been established and grouped according to international classification of diseases and health-related problems -10th edition (ICD-10). The Kaplan-Meier survival analysis was used to estimate the cumulative survival rates in all the subpopulations, and the predictive values of different variables were assessed by Cox proportional-hazards regression model.

Results: The total all-cause 12-year, unadjusted mortality was 21.1% in integrated care versus 24.6% in mixed care (p<.68). The Cox regression was not revealed for integrated care as a predictive factor for all-cause mortality.

Conclusions: The findings showed that there was no consistent evidence to support integrated inpatient care over mixed care, as measured by long-term survival. More studies are required in order to address the challenges posed in the treatment of DDPs.