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Dual diagnosis among older adults co-occurring substance abuse and psychiatric illness
- Authors:
- BARTELS Stephen J., et al
- Journal article citation:
- Journal of Dual Diagnosis, 2(3), 2006, pp.9-30.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The goal of this article is to provide a comprehensive critical review of studies reporting the prevalence, characteristics, outcomes, and service utilization associated with comorbid substance abuse and mental illness in older age. The study searched the Medline and PsycINFO databases using combinations of the keywords 'Dual diagnosis,' 'Elderly,' and 'Older.' English-language reports presenting quantitative data on the prevalence and/or any descriptive information about older adults with dual diagnosis were included. The prevalence of older adults with comorbid substance abuse and mental disorders varies by population, and ranges from 7% to 38% of those with psychiatric illness and from 21% to 66% of those with substance abuse. Depression and alcohol use are the most commonly cited co-occurring disorders in older adults. Dual diagnosis in older adults is associated with increased suicidality and greater inpatient and outpatient service utilization. Data on treatment are limited. However, recommendations have been adapted from evidence-based treatment of younger adults with dual diagnosis, older adults with substance abuse, and older adults with mental health problems. The authors concluded that dual diagnosis among older adults is a growing public health problem. Well-designed prevention, early intervention, and treatment studies are needed that specifically address co-occurring disorders in older adult populations.