Comorbid Mental and Substance Disorders among Older Psychiatric Patients

OBJECTIVE: To investigate the rate and configurations of current comorbid mental and substance disorders among older psychiatric patients. DESIGN: A descriptive, retrospective study. SETTING: A non-acute, public residential psychiatric treatment facility for adults 55 years of age and older (mean length of stay: 3 months). PATIENTS: 128 patients discharged during a 2-year period. MEASURES: DSM-III-R diagnoses, demographic and history data. RESULTS: The overall prevalence rate of concurrent mental and substance disorders during the present treatment episode was 21%. This is comparable to the 6-month rate of 19.8% found in the Epidemiological Catchment Area Study among adults in treatment (all ages). Nearly 50% of the dually diagnosed subsample received more than two diagnoses, with 60% of the subsample receiving a personality disorder diagnosis. Concurrent affective, alcohol, and personality disorder diagnoses were common. CONCLUSION: Older patients with comorbid substance-use and mental disorders may differ substantively from comorbid younger patients. Among older patients in an intermediate-term psychiatric facility, the triple occurrence of alcoholism personality disorder and depression was common.