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Drug and Alcohol Problems among Individuals with Severe Mental Illnesses in South London

Published online by Cambridge University Press:  02 January 2018

Paulo R. Menezes ,
Sonia Johnson ,
Graham Thornicroft ,
Jane Marshall ,
David Prosser ,
Paul Bebbington  and
Elizabeth Kuipers
Paulo R. Menezes*
Affiliation:
Institute of Psychiatry, London
Sonia Johnson
Affiliation:
Institute of Psychiatry, London
Graham Thornicroft
Affiliation:
Institute of Psychiatry, London
Jane Marshall
Affiliation:
Maudsley Hospital and National Addiction Centre, London
David Prosser
Affiliation:
Behavioural Psychotherapy Unit, Bethlem Royal Hospital, London
Paul Bebbington
Affiliation:
Social and Epidemiological Psychiatry Unit, Institute of Psychiatry, London
Elizabeth Kuipers
Affiliation:
Department of Psychology, Institute of Psychiatry, London
*
Paulo Menezes, Maudsley Continuing Care Study, Institute of Psychiatry, De Crespigny Park, London SE5 8AF. Fax: (0171) 277 1462
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Abstract

Background

High rates of comorbid alcohol and drug disorders have previously been found among individuals with severe mental illnesses such as schizophrenia and bipolar affective disorders. Clinical and social outcomes have been reported to be worse in this group and service costs greater than in individuals with severe mental illness only. These ‘dual diagnosis’ patients have mainly been investigated in the USA, and there has been very little research in Europe, where patterns of substance abuse may be different.

Method

All patients with psychotic illnesses who had any contact with the mental health services in a geographically defined sector in South London over a specified period were studied. Individuals with problems related to alcohol or drugs were identified using standardised interviews with subjects and their keyworkers. Data on psychiatric service use during the previous 2 years were also obtained.

Results

One hundred and seventy-one subjects with psychotic illnesses were interviewed (response rate: 78.4%). The one-year prevalence rate for any substance problem was 36.3% (95% CI=29.1–43.5), for alcohol problems it was 31.6% (95% CI=24.6–38.5), and for drug problems 15.8% (95% CI=10.3–21.3). Young male subjects were at higher risk of having substance problems. Patients with substance problems had spent almost twice as many days in hospital as those without such problems over the previous two years (difference=26.3 days, 95% CI=3.8–48.7).

Conclusions

The prevalence of substance problems among people suffering from severe mental disorders is high, and seems to be associated with greater use of in-patient services. This is a significant clinical problem, with cost implications. Further investigation is needed for adequate service provision.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 5 , May 1996 , pp. 612 - 619
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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