Integrated Treatment to Persons With Mental Disorders and Co-occurring Substance Use Disorders

Patients with mental disorders and co-occuring substance use disorders are characterized by high suicide rates, high treatment drop-out rates and long-lasting interpersonal, work, school, health and legal problems. Because mental disorders and substance use disorders co-exist and interact, it may be important to provide a treatment that addresses the substance misuse and mental health problems in an integrated and comprehensive way. Additionally, the health services for patients with mental health and substance use disorders are usually provided by different services and health professionals that rarely cooperate or have qualifications on both kinds of disorders. This also calls for an integration of the services on an organizational level. This approach of integrating services and treatment approaches for both diseases in a comprehensive way is called Integrated Treatment. Several studies have shown that Integrated Treatment is effective in treating the comorbidity of severe mental illness and substance use disorders. The over-all aim of this study is to evaluate the effects of evidence-based Integrated Treatment in anxiety and/or depression with co-occurring substance use disorders. The effects of the treatment will be assesses on changes in substance use and psychopathology.

Comparison: patients receiving treatment-as-usual or non-manualized treatment at general mental health outpatients clinics.

Inclusion criteria

• clinical diagnosis of substance use disorder
• clinical diagnosis of anxiety disorders
• clinical diagnosis of nonpsychotic mood disorders
• written consent
• planning to live in the catchment area during the treatment

Exclusion criteria

• schizophrenia spectrum disorders
• other psychotic disorders
• mental retardation
• nicotine abuse/dependency only
• prescription drug abuse/dependency only
• planning to move out of the catchment area during the study
• not able to read or write Norwegian