Comorbidity of mental disorders with alcohol and drug abuse (Revue of the problem dual diagnose)

Abstract During the pandemic, deaths associated with mental health deterioration due to social stress have contributed to excess mortality. The purpose of the study is to evaluate changes in mortality from causes associated with social stress during the pandemic in Moscow. The analysis is based on the Rosstat statistics and RFS-EMIAS database (Medical death certificates issued by the Moscow health institutions) in 2019-2020. Deaths from mental disorders and suicides during the maximum and minimum excess mortality in Moscow in 2020 were compared to 2019 (May and December, when mortality exceeded the 2019 indicators by 57.2% and 56.7%, and July with the 7.1%) excess. First, the excess mortality from mental disorders in these months was almost entirely due to disorders related to alcohol and drug abuse. Second, alcohol and drug abuse also results in deaths from poisoning. This necessitates a joint evaluation of deaths associated with alcohol and drugs (from mental disorders and poisoning). The evaluation shows that excess deaths from alcohol abuse in men in May 2020 compared to May 2019 equaled to 65%, falling down to 52.3% in July, followed by its maximum (2.5-fold) in December. Females show a steady increase: 52.9%, 76.5% and 2.1-fold, respectively. Distribution by sex of the total deaths associated with drug addiction (mental disorders and poisoning) was reversed: a steady increase in males (55.4% in May, 67% in July and 2.1-fold in December) and a significant decrease in females: 63.6%, 31.6% and 2.7-fold, respectively. Third, the pandemic has paradoxically affected deaths from suicide (including hangings, falls and undetermined intent poisoning). In men, excess deaths equaled to zero in May, 1.2% in July and decreased by 20.6% in December. The female excess suicidal mortality increased: 13.5%, 30.6% and 36.7%, respectively. Thus, the male reaction to social stress caused by the pandemic was passive (alcohol and drug abuse), while the female reaction was aggravated by suicides. Key messages During the pandemic, deaths associated with mental health deterioration due to social stress contributed to excess mortality. Alcohol and drug abuse results in deaths not only due to mental disorders.

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Clinical and Social Characteristics of Patients with Schizophrenia and Organic Mental Conditions Who Committed a Repeated Socially Dangerous Act

Doctor Ru ◽

10.31550/1727-2378-2021-20-5-62-66 ◽

2021 ◽

Vol 20 (5) ◽

pp. 62-66

Author(s):

S.N. Popov ◽

◽

I.N. Vinnikova ◽

A.S. Berezkin ◽

◽

...

Keyword(s):

Risk Factors ◽

Drug Abuse ◽

Mental Disorders ◽

Comparison Group ◽

Social Characteristics ◽

Study Group ◽

Organic Mental Disorders ◽

Group A ◽

Alcohol And Drug Abuse ◽

Group B

Study Objective: To compare clinical and social characteristics of patients with schizophrenia and organic mental conditions who committed a repeated socially dangerous acts (SDAs), not only in order to compare, but also to identify specific SDA risk factors. Study Design: comparative study. Materials and Methods. The study included 86 schizophrenia patients (study group) and 45 patients with organic mental conditions who committed SDAs, were found insane and were forced to undergo various court-appointed therapies for 2 and more times. In this study, we used the clinical psychopathologic method with due account to psychopathology and clinical statistic method as the main methods. Study Results. Hereditary load study demonstrated that in the study group (А) 35 (40.7%) out of 86 patients had hereditary exogenous conditions (pi < 0.05), while in controls (B) 9 (20%) out of 45 patients had such conditions (pi < 0.01). The number of patients without hereditary load was comparable in both groups: 45 (52.3%) vs. 24 (53.3%), respectively. In schizophrenia patients, only 6 (7%) patients had confirmed hereditary endogenous conditions, while in comparison group (B) this value was 9 (20%). Combined hereditary load was recorded only in controls: 3 (6.6%) patients. Almost all patients in comparison group (B) did not have a place work (44 (97.8%); pi < 0.01), while in the study group (A) the unemployed made 44 (51.1%). During the study, 45 (52.3%) patients in group (A) had associated bad habits (alcohol and drug abuse); 14 (16.3%) patients had both alcohol and drug abuse. 23 comparison group (B) patients had various bad habits; combined abuses were recorded in 8 (17.8%) cases. Alcohol and drug abuse were not diagnosed in 20 (23.2%) patients in study group and in 4 (8.9%) patients in controls. Conclusion. Data analysis demonstrates the clinical-social factors are noted in study groups and affect criminal behaviour and a probability of repeated SDAs in the future (with identification of factors specific for each nosological factor group). We have also identified differences in risk factors of a repeated SDA between patients with organic mental disorders and schizophrenia. Keywords: schizophrenia, organic mental disorders, repeated socially dangerous acts.

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