Drafting a dual diagnosis program: a tailored intervention for patients with complex clinical needs

Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip, Giovanni Laviola, Simone Macri, Rosanna Mancinelli

Research output: Contribution to journalArticle

Abstract

Background: Clinical practice of mental health services changed in 1978 after the Basaglia Law was passed, and it is now characterized by usually voluntary treatments offered by community-based services. That broadened the interventions’ focus from the single subject to their environment. Dual diagnosis is defined by WHO as «the co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder». It is considered to be a “border territory” since entails networking between different medical services.

Materials and methods: A literature search was performed in PubMed, Web of Science, Scopus and Google Scholar. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “psychiatric illness”, “outpatient”, “inpatient”, “health care service”, “clinical practice”. National and regional regulations about health and addiction were screened too. Out of 598 titles, 31 studies were included in this article for their relevance on treatments and networking between services for dual diagnosis cases.

Results: There are not any guidelines for clinical practice in the literature, neither there are any shared treatment strategies on a national level. Considering the autonomy that every regional health service has, several different courses of action are possible. Here there are reported the ones available.

Conclusions: After discussing the weak points of the treatment options, we suggest the “Multidisciplinary Healthcare” model to best address the difficulties represented by dual diagnosis cases.

Original languageEnglish
Pages (from-to)149-153
Number of pages5
JournalRivista di Psichiatria
Volume53
Issue number3
DOIs
Publication statusPublished - Jun 19 2018

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Dual (Psychiatry) Diagnosis
Health Services
Substance-Related Disorders
Delivery of Health Care
Therapeutics
Social Welfare
Mental Health Services
Practice Guidelines
PubMed
Psychiatry
Comorbidity
Inpatients
Outpatients
Alcohols
Guidelines
Health

Keywords

  • Alcoholism/rehabilitation
  • Community Mental Health Services/organization & administration
  • Community Networks/organization & administration
  • Deinstitutionalization/legislation & jurisprudence
  • Diagnosis, Dual (Psychiatry)
  • Disease Management
  • Health Workforce/legislation & jurisprudence
  • Humans
  • Interdisciplinary Communication
  • Italy
  • Mental Disorders/rehabilitation
  • National Health Programs/organization & administration
  • Patient Care Team
  • Practice Guidelines as Topic
  • Rehabilitation Centers/organization & administration
  • Therapeutic Community

Cite this

Drafting a dual diagnosis program : a tailored intervention for patients with complex clinical needs. / Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip ; Laviola, Giovanni; Macri, Simone; Mancinelli, Rosanna.

In: Rivista di Psichiatria, Vol. 53, No. 3, 19.06.2018, p. 149-153.

Research output: Contribution to journalArticle

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abstract = "Background: Clinical practice of mental health services changed in 1978 after the Basaglia Law was passed, and it is now characterized by usually voluntary treatments offered by community-based services. That broadened the interventions’ focus from the single subject to their environment. Dual diagnosis is defined by WHO as «the co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder». It is considered to be a “border territory” since entails networking between different medical services.Materials and methods: A literature search was performed in PubMed, Web of Science, Scopus and Google Scholar. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “psychiatric illness”, “outpatient”, “inpatient”, “health care service”, “clinical practice”. National and regional regulations about health and addiction were screened too. Out of 598 titles, 31 studies were included in this article for their relevance on treatments and networking between services for dual diagnosis cases.Results: There are not any guidelines for clinical practice in the literature, neither there are any shared treatment strategies on a national level. Considering the autonomy that every regional health service has, several different courses of action are possible. Here there are reported the ones available.Conclusions: After discussing the weak points of the treatment options, we suggest the “Multidisciplinary Healthcare” model to best address the difficulties represented by dual diagnosis cases.",
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AU - Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip

AU - Vitali, Mario

AU - Sorbo, Francesca

AU - Mistretta, Martino

AU - Coriale, Giovanna

AU - Messina, Marisa Patrizia

AU - Alessandrini, Giovanni

AU - Attilia, Fabio

AU - Rotondo, Claudia

AU - Gencarelli, Simona

AU - Ledda, Roberta

AU - Galli, Domenica

AU - Ceccanti, Mauro

AU - Laviola, Giovanni

AU - Macri, Simone

AU - Mancinelli, Rosanna

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AB - Background: Clinical practice of mental health services changed in 1978 after the Basaglia Law was passed, and it is now characterized by usually voluntary treatments offered by community-based services. That broadened the interventions’ focus from the single subject to their environment. Dual diagnosis is defined by WHO as «the co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder». It is considered to be a “border territory” since entails networking between different medical services.Materials and methods: A literature search was performed in PubMed, Web of Science, Scopus and Google Scholar. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “psychiatric illness”, “outpatient”, “inpatient”, “health care service”, “clinical practice”. National and regional regulations about health and addiction were screened too. Out of 598 titles, 31 studies were included in this article for their relevance on treatments and networking between services for dual diagnosis cases.Results: There are not any guidelines for clinical practice in the literature, neither there are any shared treatment strategies on a national level. Considering the autonomy that every regional health service has, several different courses of action are possible. Here there are reported the ones available.Conclusions: After discussing the weak points of the treatment options, we suggest the “Multidisciplinary Healthcare” model to best address the difficulties represented by dual diagnosis cases.

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KW - Health Workforce/legislation & jurisprudence

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KW - Mental Disorders/rehabilitation

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KW - Patient Care Team

KW - Practice Guidelines as Topic

KW - Rehabilitation Centers/organization & administration

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