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Comorbid mental and substance disorders among older psychiatric patients
1Florida Mental Health Institute, Department of Aging and Mental Health, University of South Florida, Tampa.
Objective:
To investigate the rate and configurations of current comorbid mental and substance disorders among older psychiatric patients.
Design:
A descriptive, retrospective study.
Setting:
A non-acute, public residential psychiatric treatment facility for adults 55 years of age and older (mean length of stay: 3 months).
Patients:
128 patients discharged during a 2-year period.
Measures:
DSM-III-R diagnoses, demographic and history data.
Results:
The overall prevalence rate of concurrent mental and substance disorders during the present treatment episode was 21%. This is comparable to the 6-month rate of 19.8% found in the Epidemiological Catchment Area Study among adults in treatment (all ages). Nearly 50% of the dually diagnosed subsample received more than two diagnoses, with 60% of the subsample receiving a personality disorder diagnosis. Concurrent affective, alcohol, and personality disorder diagnoses were common.
Conclusion:
Older patients with comorbid substance-use and mental disorders may differ substantively from comorbid younger patients. Among older patients in an intermediate-term psychiatric facility, the triple occurrence of alcoholism personality disorder and depression was common.
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