Presence of dual diagnosis between users and non-users of licit and illicit drugs in Brazil

Formiga, Mariana Bandeira; Vasconcelos, Selene Cordeiro; Galdino, Melyssa Kellyane Cavalcanti; Lima, Murilo Duarte da Costa

doi:10.1590/0047-2085000000091

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Artigos Originais • JBPSIQJ. bras. psiquiatr. 64 (4) • Oct-Dec 2015 • https://doi.org/10.1590/0047-2085000000091 copy

Presence of dual diagnosis between users and non-users of licit and illicit drugs in Brazil

Presença de diagnóstico duplo entre usuários e não usuários de drogas lícitas e ilícitas no Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

Investigate the occurrence of dual diagnosis in users of legal and illegal drugs.

Methods

It is an analytical, cross-sectional study with a quantitative approach, non-probabilistic intentional sampling, carried out in two centers for drug addiction treatment, by means of individual interviews. A sociodemographic questionnaire, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Mini-International Neuropsychiatric Interview (MINI) were used.

Results

One hundred and ten volunteers divided into abstinent users (group 1), alcoholics (group 2) and users of alcohol and illicit drugs (group 3). The substances were alcohol, tobacco, crack and marijuana. A higher presence of dual diagnosis in group 3 (71.8%) was observed, which decreased in group 2 (60%) and 37.1% of drug abstinent users had psychiatric disorder. Dual diagnosis was associated with the risk of suicide, suicide attempts and the practice of infractions. The crack consumption was associated with the occurrence of major depressive episode and antisocial personality disorder.

Conclusion

It was concluded that the illicit drug users had a higher presence of dual diagnosis showing the severity of this clinical condition. It is considered essential that this clinical reality is included in intervention strategies in order to decrease the negative effects of consumption of these substances and provide better quality of life for these people.

Substance use disorder; drug users; dual diagnosis; psychiatric comorbidity

Variable	Groups						Total group
	Group 1 (Abstinent users, except for tobacco)		Group 2 (Alcohol users)		Group 3 (Users of alcohol and other drugs)		Total group

	N	%	N	%	N	%	N	%
TOTAL	35	31.8	36	32.7	39	35.5	110	100
Age: Mean + SD	49.11	DP = 10.78	44.7	DP = 9.47	32.51	DP = 9.94	41.73	DP = 12.25
Genre
Male	32	91.4	32	88.9	34	87.2	98	89.1
Female	3	8.6	4	11.1	5	12.8	12	10.9
Colour	2	5.7	2	5.6	5	12.8	09	8.2
White	22	62.9	22	61.1	20	50.3	64	58.2
Black	11	31.4	12	33.3	14	35.9	37	33.6
Mulato
Marital status
Single	17	48.6	13	36.1	26	66.7	56	51
Married/Common-law marriage	10	28.1	8	22.2	2	5.1	30	27.2
Divorced/Separated	07	20	15	41.7	11	28.2	23	20.9
Widow	01	2.9	00	00	00	00	01	0.9
Education
Up to 9 years of study	19	54.3	25	69.4	28	71.8	72	65.5
More than 9 years of study	16	45.7	11	30.6	11	28.2	38	34.5
Occupation
Student	01	2.9	01	2.8	02	5.1	04	3.6
Worker (Formal or informal)	11	31.4	17	47.2	11	28.2	39	35.4
Unemployed	12	34.3	10	27.8	19	48.7	41	37.2
Retired	11	31.4	08	22.2	07	17.9	26	23.6
Income: n (%)
No income	19	54.3	17	47.2	22	56.4	58	52.7
Up to 1 minimum wage	07	20	09	25	08	20.5	24	21.8
More than 2 minimum wages	09	25.7	09	25	07	17.9	25	22.7
Governmental aid	00	00	01	2.8	02	5.1	03	2.7
Criminal acts
Yes	13	37.1	16	44.4	24	61.5	53	48.2
No	22	62.9	20	55.6	15	38.5	57	51.8
Frequency in the service
1 day	03	8.6	00	00	02	5.1	05	4.5
2 days	08	22.9	06	18.2	05	12.8	19	17.3
3 days or more	22	62.9	26	72.2	24	61.5	72	65.5
Inmate	00	00	01	03	02	5.1	03	2.7
No fixed frequency	02	5.7	03	9.1	06	15.4	11	10
Previous treatment for SUD
Yes	19	54.3	20	55.6	23	59	62	56.4
No	16	45.7	16	44.4	16	41	48	43.6

Variable	Groups				Total group	Value of p
	Group 1 (Abstinent users, except for tobacco)	Group 2 (Alcohol users)		Group 3 (Users of alcohol and other drugs)	Total group

	%		%	%	%
TOTAL	31.8		32.7	35.5	100
Presence of PD:	37.1		60	71.8		p⁽¹⁾ < 0.01 χ² = 9.23
Mood disorders
Current major depressive episode	22.9		52.8	56.4	44.5	p⁽¹⁾ < 0.007 χ² = 9.87
Psychotic syndrome lifetime	2.9		5.7	12.8	7.3	p⁽¹⁾ < 0.22 χ² = 2.94
Anxious disorders
Social phobia	2.9		11.1	10.3	8.2	p⁽¹⁾ < 0.37 χ² = 1.95
Obsessive-compulsive disorder	2.9		5.7	2.6	3.6	p⁽¹⁾ < 0.75 χ² = 0.56
Generalized anxiety disorder	2.9		17.1	17.9	12.7	p⁽¹⁾ < 0.10 χ² = 4.53
Panic disorder with or without agoraphobia	00		5.7	7.7	4.5	p⁽¹⁾ < 0.26 χ² = 2.64
Agoraphobia without panic disorder	2.9		8.6	7.7	6.4	p⁽¹⁾ < 0.58 χ² = 1.07
Post-traumatic stress	8.6		14.3	12.8	11.8	p⁽¹⁾ < 0.76 χ² = 0.54
Antisocial personality disorder	5.7		2.9	23.1	10.9	p⁽¹⁾ < 0.009 χ² = 9.36
Suicide
Risk of suicide	5.7		20	33.3	20	p⁽¹⁾ = < 0.01 χ² = 8.80
Attempted suicide	31.4		41.7	46.2	40	p⁽¹⁾ < 0.42 χ² = 1.72

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