title: [Survival following the first admission in an integrated dual disorders treatment ward (IDDTW): preliminary results from a cohort study].
abstract: BACKGROUND
  Dual disorders (co-occurring severe mental illness [SMI] and substance abuse disorders in the same person) are extremely common among patients receiving mental health services. Dual disorders are associated with increased all-cause mortality, as compared with patients with SMI. Scientific evidence is lacking on the survival of dual disorders subjects, who had psychiatric inpatient care.
  
  
  OBJECTIVE
  To determine the long term survival rates of patients after the first admission in an IDDTW and to identify their baseline predictors.
  
  
  METHODS
  The charts of 258 subjects admitted to IDDTW during the period 2002-2004 were assessed at least 8 years after the first admission. Psychiatric diagnoses were established and grouped according to the International Statistical Classification of Diseases and Related Health Problems 10th edition (ICD-10). The Kaplan-Meier survival analysis was used to estimate the cumulative survival rates, and the predictive values of different variables were assessed by Cox proportional-hazards regression model.
  
  
  RESULTS
  The cumulative 1-, 2-, 4-, 6- and 8-year survival rates of all subjects were 98.06%, 96.51%, 91.47, 86.43% and 81.78%, respectively, without statistically significant differences between subgroups of psychiatric diagnoses. Multivariate Cox regression analysis revealed that the age at death was the only independent predictor of all-cause mortality (hazard ratio = .96; 95% confidence interval .93 to .99; p < .009).
  
  
  CONCLUSIONS
  Those of young age are at a particularly low risk of long term survival. More targeted health care is required to address the specific needs of this vulnerable subgroup. Further research of survival into specific risk groups is required.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Gimelfarb
authors.forename: Ety
authors.initials: E
authors.lastname: Becatel
authors.forename: Aviva
authors.initials: A
authors.lastname: Wolf
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Baruch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D001523:Mental Disorders / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012044:Regression Analysis; D019966:Substance-Related Disorders / Q000401:mortality / Q000534:rehabilitation*; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult