Comorbidità psichiatrica in disturbi da uso di sostanze: studio preliminare su profili di gravità e medicazioni psicofarmacologiche

Background. The aim of this study is to assess the prevalence of psychiatric comorbidity in a group of patients with Substance Use Disorders focusing the psycho-tropic drugs and the severity scores carried out from the European adaptation of the Addiction Severity Index (Europ-ASI). It is a naturalistic analysis on the first data from wider study with a control group and a follow-up. Methods. The present study becomes within the Experimental Project Psychiatric comorbidity substance use disorders funded by the Region of Lombardy and managed by the Psychiatric Operative Unit and the Psychiatric Clinic of the University of Pavia. Through cooperation between the Addicts outpatient centre, auxiliaries facilities for addicts and the Psychiatric ward of the General Hospital in Pavia a Psychiatric consultation service was arranged for patients with mental disorders and Substance Use Disorders. Every patient sent to this service, which gives multidimensional evaluation and psychiatric treatments, was recruited. In the sample there are 37 patients, almost all males, about thirty years old. For everyone a diagnostic clinic evaluation and a Global Functioning evaluation from the DSM IV criteria were carried out, as well as a semi-structured evaluation of substance abuse and the social and relations-related aspects through the Europ-ASI. Results. We report high opioids use and a low rate of abstinence during the last 30 days, a low prevalence of false positives reading psychiatric comorbidity, a homogeneous distribution of diagnostic subgroups and of Global Functioning scores, a high use of Methadone in the therapy in patients with Affective Disorders. The severity scores in every area of the Europ-ASI underline the importance of psychiatric and addiction-related problems, quite equally distributed within the diagnostic subgroups. Conclusions. We underline, as previous studies, the importance of symptom severity beyond the specific diagnosis.