3. Psychiatric comorbidity in the European countries: prevalence and models of care

Mental and substance use disorders (SUD) are related with 7% of the global burden of disease -measured in Disability-adjusted life years (DALYs)- and significant mortality rates. At present, it is crucial to perform accurate diagnoses of psychiatric comorbidity in SUD patients as well as, to offer a comprehensive treatment approach.

The aims are to present an update on the epidemiological data on psychiatric comorbidity in Europe and an overview of available interventions targeting people with mental health and drug use disorders and the evidence of their effectiveness.

A review of existing literature combined with information reported in previous EMCDDA Insights will be performed. Results from a pilot data collection on mental health disorders among people entering drug treatment in the European countries will be presented. A critical evaluation of the different treatment models, including their effectiveness, and barriers for their implementation will be presented.

Prevalence of comorbid mental disorders in people who use drugs is higher than in general population, however, data is heterogenous, depending on methodological issues, the type of the disorder (affective, psychosis, anxiety, etc.), the type of SUD, and, the setting in which the diagnosis has been carried out.

Many countries have two separate networks for the treatment of mental illness and for the treatment of SUD. This implies that patients with comorbidity could be treated in two facilities (parallel treatment model), sometimes with a requisite of a previous drug abstinence (sequential treatment model).

Psychiatric comorbidity in SUD is frequent, with high severity in both disorder type, and also with poor social functioning. In terms of treatment approach and integrated model is highly recommended.