Severity profiles of substance-abusing patients in Italian community addiction facilities: influence of psychiatric concurrent disorders.

Mental health and addiction services have traditionally evolved separately in many European countries, with policy reflecting this. Differences in severity profiles between users of the community addiction services with comorbidities of mental illness and substance misuse and those with substance misuse only were studied using a matched case-control study design, with regard to the main substance (opiates or cocaine) patients were dependent on. Patterns of substance abuse and diagnostic features were evaluated according to the Addiction Severity Index (ASI) and DSM-IV. Mentally ill substance abusers are significantly more likely to have used amphetamines, inhalants and having been polydrug users. They are particularly impaired in medical and family/social relationships ASI composite scores, but less in drug use. Severity profiles and needs of dually diagnosed patients require assessment and treatment skills that should be provided through adequate links with mental health system.