Sammanfattning
Background: Dual diagnosis (DD) is a common co-morbidity of mental illness and substance use
disorder (SUD) and patients with DD are prone to complications. Better knowledge on the outcome,
mortality and management of patients with DD in usual secondary psychiatric care would help to
inform improved treatment strategies in the future. Aims: To explore the functional outcome and
mortality of patients with DD receiving psychiatric treatment. To assess the recognition of substance
use disorders (SUDs) in terms of diagnosis, and the associations of clinically diagnosed SUDs with
treatment-related variables. Methods: The sample of 330 patients was collected by screening all
currently treated patients with the Alcohol Use Disorders Identification Test (AUDIT) and a question
about other substances used. The inclusion criteria were AUDIT>7 and/or reported use of other
substances during the preceding 12 months. The Global Assessment of Functioning scale was used
to assess functional outcomes during a 2-year follow-up. Information concerning treatment and
patient characteristics was collected retrospectively. Results: Level of functioning remained stable
among all study patients during follow-up. The mortality rate was not increased. Effective medication
use was associated with improved functional outcomes. SUDs were underdiagnosed. A clinically
diagnosed SUD seemed to have an impact on the regularity of appointments and the doses of
prescribed medications. Conclusions: Given our results suggesting a stable level of functioning,
patients with DD appear to be well managed within secondary psychiatric care. Attention should be
paid to more precise diagnostics of SUDs and to effective use of medication.