title: Trends in dual diagnosis of severe mental illness and substance use disorders, 1996-2010, Israel.
abstract: OBJECTIVE
  (1) To examine the trends in the incidence of dual diagnosis (DD) of severe mental illness and substance-related disorders among inpatients in Israel, and (2) the demographic and clinical correlates of DD patients.
  
  
  METHODS
  Using data from the National Psychiatric Case Register, we identified 56,774 inpatients aged 15-64 whose first psychiatric hospitalization occurred between 1996 and 2010. We compared the characteristics of inpatients having DD with drugs, alcohol or drug/alcohol abuse with those with mental disorder only.
  
  
  RESULTS
  Over the period, DD with drugs decreased from 8.2% in 1996 to 6% in 2010; DD with alcohol increased from 3% to 4% and DD with drugs/alcohol from 2% to 4%. DD with drugs was highest, whereas DD with alcohol was lowest for the youngest age- group in 1996 but increased to the same as other age-groups in 2006-2010. Male gender, a previous suicide attempt, compulsory hospitalizations and marital status were positive predictors for all DD. Immigrant status was a positive predictor of DD with alcohol, but the opposite for DD with drugs; being Jewish and psychotic diagnosis was a positive predictor of DD with drugs, but negative for DD with alcohol.
  
  
  CONCLUSIONS
  Over the study period, DD with drugs has decreased among young patients, although it is still higher than among older groups. However, DD with alcohol or drugs/alcohol has increased in the younger group. The clinical-demographic profile of DD patients was similar to that from the relevant literature, except for immigrant status that was negatively associated with DD with drugs.
authors: Research Unit, Mental Health Services, Ministry of Health, Jerusalem, Israel. Electronic address: alexander.ponizovsky@moh.health.gov.il.
authors: Alexander M
authors: AM
authors: Ponizovsky
authors: Department for the Treatment of Substance Abuse, Mental Health Division, Ministry of Health, Jerusalem, Israel.
authors: Paola
authors: P
authors: Rosca
authors: Division of Health Information, Ministry of Health, Jerusalem, Israel.
authors: Ziona
authors: Z
authors: Haklai
authors: Division of Health Information, Ministry of Health, Jerusalem, Israel.
authors: Nehama
authors: N
authors: Goldberger
mesh_terms: D000293:Adolescent; D000328:Adult; D017831:Diagnosis, Dual (Psychiatry) / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Dual diagnosis; Incidence; Israel; Mental disorder; Substance related disorder; Temporal trends