“Dual diagnosis” and use of healthcare resources in psychiatric care services. The experience of Monza and Brianza

“Doppia diagnosi” e consumo di risorse sanitarie nel DSM. L’esperienza di Monza e Brianza

E. Giampieri1, A. Alamia1, G.L. Galimberti2, B. Tinghino2, M. Resentini2, M. Clerici1,3

1 DSM, AO San Gerardo, Monza; 2 Dipartimento Dipendenze, ASL Monza e Brianza; 3 Dipartimento di Chirurgia e Medicina Interdisciplinare, Università di Milano Bicocca


Patients with dual diagnosis have more social, relational and clinical issues than patients with either psychiatric or drug problems.


The aim of the present study was to compare patients that receive either psychiatric care or drug treatment with those that receive both types of treatment, in order to evaluate differences in care needs and costs.


We recruited 4387 patients from psychiatric care services, 1420 from drug-treatment services and 178 patients treated by both services. Data about psychiatric patients was collected from Psiche (psychiatric database of Lombardy), while data about drugabusers from Sesit (drug-treatment services database). We then matched the two databases to obtain a list of patients followed by both services, which were then considered as patients with dual diagnosis. SPSS version 18 was used for statistical analysis.


Patients with dual diagnosis, compared to only psychiatric patients, received their first psychiatric treatment when younger (36.36 ± 10.90 vs. 39.66 ± 14.45 years), while they initiated treatment for drug problems at the same age of drug abusers (32.84 ± 9.48 vs. 32.91 ± 8.51 years). Patients with a personality disorder, among only psychiatric patients, had the earliest age of onset (33.98 ± 10.95 years), while among patients with dual diagnosis schizophrenic patients had the earliest age of onset (30.92 ± 9.47 year). Globally, psychiatric treatment of patients with dual diagnosis lasted 1.5 years less than treatment of psychiatric patients, while drug-treatment of patients with dual diagnosis lasted one year more than drug-abusers. Patients with dual diagnosis also needed a significant higher number of different healthcare professionals per year (2.39 ± 1.58 vs. 2.02 ± 1.35) and more different types of intervention (2.53 ± 1.90 vs. 2.18 ± 1.63) compared to only psychiatric patients.


Patients with dual diagnosis need a greater amount of care and more complex interventions compared to patients with either psychiatric disorder or drug-abuse alone.

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