Investigation on the incidence and management of dual diagnosis in young people: the experience of a local health authority in central Italy

Abstract

BACKGROUND: Dual Diagnosis (D.D.), defined by the WHO as the coexistence of a psychiatric disorder and a substance use disorder in the same individual, represents a significant challenge for nurses working in Mental Health and Addiction Services. These patients require complex care pathways, with positive outcomes strongly dependent on individualized approaches. Aim: To evaluate the most frequent care management modalities for patients with D.D. and the role of the Nurse Case Manager (NCM) in the care process.

METHOD: A retrospective study based on the review of Hospital Discharge Records (SDO) from a convenience sample of patients hospitalized with D.D. in two Psychiatric Diagnosis and Care Services (SPDC) in Central Italy. Independent variables (sex, age, diagnosis, treatment, substances used) were correlated with the dependent variable “care management.” Data collection took place between 01/09/2023 and 29/02/2024.

RESULTS: Of the 432 SDOs reviewed, 104 reported a diagnosis of D.D. (61 males, 43 females). Of these, 67.3% were over 25 years old. A total of 82.7% accessed psychiatric services voluntarily, while 17.3% were subject to compulsory treatment. Age was strongly correlated with the type of care management (PIPSM/CSM and Ser.D.). Demographic, diagnostic, and substance use patterns showed notable differences.

CONCLUSIONS: The care of patients with D.D. requires integrated and personalized interventions. Nurse Case Management emerges as the most effective model, ensuring continuity of care, relapse prevention, and strong connection with community services.