aim The aim of this observational study was to assess treatment outcome in a dual diagnosis population in The Hague.
method All patients admitted in 2003 were eligible. Pre-post treatment patient changes were analysed in the areas of mental health, drug use and general quality of life. Assessments were conducted at treatment entry, discharge, three and nine months after discharge.
results Ninety-three patients were admitted; 20 refused participation. Seventy percent of the population suffered from a severe mental illness (smi), mainly schizophrenia or bipolar disorders. Mean scl-90-score (Symptom Checklist 90) at treatment entry proved 224 (standard deviation (sd) 73), at discharge 173 (sd 55), and during follow- up 201 (sd 69) and 191 (sd 62). Before treatment entry cocaine was used 10 (sd 11) days/ month, while at follow-up 4 (sd 9) days/month. Poly substance use decreased from 16 (sd 12) days to 9 (sd 12) days/month. All were statistical significant differences. Both the addiction severity index drugs and days spent in a controlled environment decreased significantly. Patients reported a significant improvement in quality of life (Lehman questionnaire).
conclusion This study shows that the integrated treatment, both in- and outpatient, yields good results. Improvement is sustained even nine months after discharge. In view of the unfavourable impact of substance abuse on the course of smi, the observed decrease in substance abuse is very promising. General improvement on mental health and quality of life occurred, even without abstinence.