Aslı Enez DARÇIN, Serdar NURMEDOV, CEMAL ONUR NOYAN, Onat YILMAZ, Nesrin DİLBAZ

Psychiatric Comorbidity Among Inpatients in an Addiction Clinic and Its Association with The Process of Addiction

Amaç: Epidemiyolojik çalışmalar madde kullanım bozukluğu olan erişkinlerde diğer bir Eksen I ve Eksen II tanısının sıklıkla eştanı olarak bulunduğunu göstermektedir. Bu çalışma yatan madde kullanım bozukluğu hastalarında Eksen I ve Eksen II eştanılarının sosyodemografik değişkenler ile relaps arasındaki ilişkisini araştırmayı amaçlamaktadır.Yöntem: Bu geriye dönük çalışmaya bir bağımlılık kliniğinde Ocak 2012-Aralık 2013 tarihleri arasında ardışık olarak yatarak tedavi gören 403 hasta içerisinden 323'ünün tıbbi kayıtları ve sosyodemografik verileri alınmıştır. Hastalar iki ayrı psikiyatrist tarafından değerlendirilerek DSM IV-TR'ye göre alkol ve madde kötüye kullanımı/bağımlılığı tanıları almışlar ve yine eştanılar da iki ayrı psikiyatri uzmanınca DSM-IV TR'ye göre konmuştur.Bulgular: Madde kullanım bozukluğu olan 323 hastanın 240'ında (%74.3) diğer bir Eksen I, 238'inde bir Eksen II (%73.7) tanısı bulunmakta idi. Eksen I ya da Eksen II eş tanısı olan ve olmayan hastalar arasında yaş, eğitim durumu, medeni durum, çalışma durumu, madde kullanım süresi, 6 aylık relaps ve tedaviden kopma oranları arasında fark yoktu. Eksen I ya da Eksen II eş tanısı yatış sayısını artırmakta idi, Eksen I eş tanısı yatış süresini uzatırken Eksen II eş tanısı tersine etki etti. Ayrıca Eksen II eştanısı olan hastalarda yasal sorun yaşama ve tedavi sonrası yeniden madde kullanımına kadar geçen sürede kısalma eştanısı olmayanlara göre daha sıktı.Sonuç: Madde kullanım bozukluklarında diğer bir Eksen I ve Eksen II eş tanısı oldukça sıktır. İkili tanısı olan hastaların yalnızca madde kullanım bozuklukları olanlara göre sağlık hizmetlerini daha sık kullandıkları ve daha fazla yasal sorun yaşadıkları söylenebilir. İkili tanısı olan hastaların kapsamlı bakım ve tedaviye ihtiyaçları vardır

Özel bir bağımlılık merkezinde yatarak tedavi gören hastalarda psikiyatrik eş tanının bağımlılığın seyri ile ilişkisi

Objective: Epidemiological studies find a high comorbidity of other Axis I and Axis II disorders with substance use disorders among adults. This study examines comorbid Axis I and Axis II disorders in order to investigate their association with sociodemographic variables and relapse among inpatients diagnosed with substance use disorders.Method: Of 403 inpatients hospitalized between January 2012 and December 2013 in an addiction clinic, 323 were enrolled in this retrospective study using their medical records and sociodemographic data. These patients were all diagnosed with alcohol and substance abuse/dependence according to DSM-IV TR by two different psychiatrists, and comorbidities were also diagnosed by two different psychiatrists.Results: Among 323 inpatients with substance use disorder, 240 (74.3%) were diagnosed with another Axis I comorbidity and 238 (73.7%) had an Axis II disorder. No statistical difference was found between patients with and without an Axis I or Axis II comorbidity in terms of age, years of education, marital status, occupation, duration of drug use, rate of relapse in 6 months, and rate of dropout. Comorbidity of an Axis I and/or Axis II disorder raised the number of hospitalizations; comorbid Axis I disorder prolonged the duration of hospitalization, whereas Axis II disorder had an inverse effect. In addition, inpatients with an Axis II comorbidity had more legal issues and shorter duration until first use after treatment than inpatients without comorbidity.Conclusion: Comorbidity of substance use disorders and other Axis I and Axis II disorders is very common. Patients with dual diagnose use health services more often and have more legal issues than patients with substance use disorders only. Comprehensive care and treatment are needed for dual-diagnosed patients

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