Prevalence and treatment of co-ocurrence of substance use disorder and other mental health disorders. A national survey in Spain.

Background: Diagnose and treatment resources and provision for people with an addictive disorder and other psychiatric disorders is an important challenge for National Health Service in Spain because there is a lack of registration and knowledge about people with dual diagnoses and of the different resources in which these patients are treated.

Objectives: A national survey of patients undergoing psychiatric or addiction treatment throughout Spain has been conducted. Health care professionals seeing patients in mental health services or addiction treatment settings completed a specific online questionnaire about diagnoses and treatment of co-occurrence of substance abuse disorder and other mental health disorders.

Methods:  Observational, multicenter study with a large, randomized, representative sample of patients with addictive or other mental health disorders throughout Spain. Health care professionals completed a specifically designed ad-hoc on-line questionnaire about diagnoses and treatments for their patients in mental health and addiction networks, recording data from more than 2000 patients.

Results: The study shows a high prevalence of substance use and other mental disorders in patients seen in addiction or mental health treatment networks. The more prevalent SUD were for alcohol and cannabis. The most frequent diagnoses of not addictive disorder were affective and personality ones. Comorbid diagnosis was found in more than 50% of patients. SUD patients were more often diagnosed with more psychiatric disorders compared with those in mental health settings. And in both, more than two SUD. We found a scarce use of some treatments for addictive disorders in mental health settings and a high prescription of benzodiazepines in addiction treatment settings.

Conclusions: Prevalence of dual diagnoses in different treatment settings and medications used for addiction disorder and for other mental health disorders was high.

The study provides valuable information on the actual prevalence and treatment for addictive and other mental disorders in Spain, showing the comorbidity in routine practice. There is a need of additional efforts and strategies for treating patients with comorbid disorders and of harmonizing registry and programs for them.