Who are the dually diagnosed?

The evaluation of mental health problems among persons with mental retardation is complicated by difficulties in diagnosis as well as by system variables that may also determine who will be assigned a dual diagnosis. In this study a state data base of 78,603 individuals with mental retardation receiving state services was examined. The relations of observed behavior problems, other characteristics of the individual, and residential placement patterns to the likelihood of being given a dual diagnosis were examined. Extrapunitive maladaptive behaviors, cognitive abilities, and social skills were associated with diagnoses of mental health problems among persons with mental retardation. The different perspectives from which these results could be interpreted were discussed.