title: Dual diagnosis and chronology of illness in treatment-seeking Italian patients dependent on heroin.
abstract: Although there are studies describing the prevalence of patients with drug addiction and dual diagnosis, there is a paucity of data regarding the progression from psychiatric disorders to drug addiction or vice versa. A total of 1,090 patients dependent on heroin were interviewed to examine the presence of dual diagnosis and the progression from psychiatric disorders to drug dependence or vice versa. A total of 574 patients met the criteria for a dual diagnosis. A total of 362 patients progressed from substance abuse disorders to psychiatric disorders (SUD-PR) and 144 patients progressed from psychiatric disorders to drug addiction (PSY-PR). SUD-PR patients are more frequently affected by mood disorders. PSY-PR patients were more frequently diagnosed as psychotic or affected by anxiety disorders. The authors' findings suggest that the self-medication theory of dual diagnosis was relevant only for those with existing diagnoses of schizophrenia or anxiety disorders. When treating patients with a dual diagnosis, clinicians should ensure that the same attention is given to the treatment of drug dependence as it is to the treatment of comorbid psychiatric conditions.
authors.affiliation: University of Pisa, Via Roma 67, 56100-PISA, Italy. maremman@med.unipi.it
authors.forename: Angelo Giovanni Icro
authors.initials: AG
authors.lastname: Maremmani
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.forename: Matteo
authors.initials: M
authors.lastname: Pacini
authors.forename: Dina
authors.initials: D
authors.lastname: Popovic
authors.forename: Luca
authors.initials: L
authors.lastname: Rovai
authors.forename: Marta
authors.initials: M
authors.lastname: Torrens
authors.forename: Giulio
authors.initials: G
authors.lastname: Perugi
authors.forename: Icro
authors.initials: I
authors.lastname: Maremmani
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006556:Heroin Dependence / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D019370:Observation; D015995:Prevalence; D011379:Prognosis; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult