Health-related quality of life in patients with dual diagnosis: clinical correlates

Abstract

Background: Although the studies published so far have found an affectation in the Health Related Quality of Life (HRQOL) in both psychiatric and substance use dependence disorders, very few studies have applied HRQOL as an assessment measure in patients suffering both comorbid conditions, or Dual Diagnosis. The aim of the current study was to assess HRQOL in a group of patients with Dual Diagnosis compared to two other non-comorbid groups and to determine what clinical factors are related to HRQOL.

Methods: Cross-sectional assessment of three experimental groups was made through the Short Form - 36 Item Health Survey (SF-36). The sample consisted of a group with Dual Diagnosis (DD; N = 35), one with Severe Mental Illness alone (SMI; N = 35) and another one with Substance Use Dependence alone (SUD; N = 35). The sample was composed only by males. To assess the clinical correlates of SF-36 HRQOL, lineal regression analyses were carried out.

Results: The DD group showed lower scores in most of the subscales, and in the mental health domain. The group with SUD showed in general a better state in the HRQOL while the group with SMI held an intermediate position with respect to the other two groups. Daily medication, suicidal attempts and daily number of coffees were significantly associated to HRQOL, especially in the DD group.

Conclusions: The DD group showed lower self-reported mental health quality of life. Assessment of HRQOL in dual patients allows to identify specific needs in this population, and may help to establish therapeutic goals to improve interventions.

Figure 1

Participants flow-chart. DD, Dual Diagnosis; SMI, Severe Mental Illness; SUD, Substance Use Dependence.

Figure 2

Mean scores for the three groups of patients and the Spanish norms in the 8 scales of the SF-36. PF, Physical Functioning; RF, Role – Physical; RE, Role – Emotional; SF, Social Functioning; MH, Mental Health; GH, General Health, BP, Bodily Pain; VT, Vitality.DD, Dual Diagnosis; SMI, Severe Mental illness, SUD, Substance Use Dependence.

Figure 3

Mean scores for the three groups of patients and the Spanish norms in the MCS and the PCS. MCS, Mental Health Component Summary; PCS, Physical Component Summary. DD, Dual Diagnosis; SMI, Severe Mental Illness, SUD, Substance Use Dependence.