Dual diagnosis and their care pathways for help-seeking: A multicenter study from India.

Autor:	Ghosh A; Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Mukherjee D; Department of Addiction Medicine, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India., Khanra S; Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India., Prasad S; Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India., Mahintamani T; Department of Addiction Medicine, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India., Basu A; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Padhy S; Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India., Suthar N; Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India., Somani A; Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India., Arya S; Department of Psychiatry, Institute of Mental Health, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India., Das B; Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India., Kumar P; Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India., Rina K; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Haokip HR; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Guin A; Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India., Mishra S; Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India., Nebhinani N; Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India., Singh LK; Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India., Gupta R; Department of Psychiatry, Institute of Mental Health, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India., Kaur R; Department of Psychiatry, Government Medical College, Chandigarh, India., Basu D; Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Jazyk:	angličtina
Zdroj:	Indian journal of psychiatry [Indian J Psychiatry] 2024 Jul; Vol. 66 (7), pp. 630-640. Date of Electronic Publication: 2024 Jul 17.
DOI:	10.4103/indianjpsychiatry.indianjpsychiatry_79_24
Abstrakt:	Background: Understanding pathways to dual diagnosis (DD) care will help organize DD services and facilitate training and referral across healthcare sectors. Aim: The aim of our study was to characterize the stepwise healthcare and other contacts among patients with DD, compare the characteristics of the first contact persons with common mental disorder (CMD) versus severe mental illness (SMI), and estimate the likelihood of receiving appropriate DD treatment across levels of contacts. Methods: This cross-sectional, descriptive study in eight Indian centers included newly enrolled patients with DD between April 2022 and February 2023. The research spans varied geographic regions, tapping into regional variations in disease burden, health practices, and demographics. The study categorized healthcare contacts by using the WHO Pathways Encounter Form. Results: The sample (n = 589) had a median age of 32 years, mostly males (96%). Alcohol was the most common substance; SMI (50.8%) and CMD were equally represented. Traditional healers were a common first contact choice (18.5%); however, integrated DD care dominated subsequent contacts. Assistance likelihood increased from the first to the second contact (23.1% to 62.1%) but declined in subsequent contacts, except for a significant rise in the fifth contact (97.4%). In the initial contact, patients with CMD sought help from public-general hospitals and private practitioners for SUD symptoms; individuals with SMI leaned on relatives and sought out traditional healers for psychiatric symptoms. Conclusion: Recognizing the cultural nuances, advocating for integrated care, and addressing systemic challenges pave the way to bridge the gap in DD treatment. Competing Interests: There are no conflicts of interest. (Copyright: © 2024 Indian Journal of Psychiatry.)
Databáze:	MEDLINE
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