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Een Dubbele Diagnose: Een inventarisatie van de prevalentie van As I en As II problematiek binnen de verslavingszorg

Stutterheim, T. (2012) Een Dubbele Diagnose: Een inventarisatie van de prevalentie van As I en As II problematiek binnen de verslavingszorg.

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Abstract:Background: Lately, increasing attention has been paid to psychiatric comorbidity in substance abuse disorders. However, there are still different findings on the prevalence of comorbid Axis I or Axis II disorders. In treatment, clients are only referred to integrated treatments, when previous treatments did not take off. Early recognition of comorbid Axis I or Axis II disorders, can contribute to both the allocation to an appropriate treatment as well as the quality of the treatment. Aim: The aim of this study is to provide a comparative assessment of the prevalence of Axis I and Axis II disorders in a population of substance abusers. In addition, possible relations between addiction information, client characteristics and Axis I and Axis II disorders, were examined in an explorative manner. Method: The required information was collected by means of questionnaires and semi-structured interviews. Data on addiction information and client characteristics were collected, using the Meten van Addicties voor Triage en Evaluatie (MATE). Subsequently, the NEO Five Factor Inventory (NEO-FFI), the MINI-plus and the structured interview for DSM personality disorders (SIDP-IV) were used to collect the data relating to the Axis I and Axis II disorders. The data was analyzed using the IBM SPSS Statistics 20 program. Results: 60,8% of the participants meet the criteria for a comorbid Axis I disorder. 20.6% of the participants meet the criteria of a depression with melancholic features, 19.6% meet the criteria of having a current depressive episode and 10.8% of the participants meet the criteria of a generalized anxiety disorder. Furthermore, 20.6% of the participants meet the criteria for having a personality disorder. Of these participants, 47.6% has a cluster B personality disorder, 38.1% have a cluster C personality disorder and 14,3% have a cluster A personality disorder. With regard to the prevalence of common Axis I and Axis II disorders, no differences were found between different addiction information. However, looking beyond the diagnostic criteria for Axis I and Axis II disorders, it appears that participants with alcohol as their primary problem substance, reported fewer depressive symptoms than other participants (p <0.05). In contrast, participants with cocaine as their primary problem substance, reported more depressive symptoms than other participants (p <0.05). Furthermore, participants with cannabis as their primary problem substance, reported more problems with regard to following education / having a job (p <0.05). Conclusion: In addiction care, clients regularly suffer from comorbid Axis I ore Axis II disorders. Therapists as well as the intake procedure, are focusing on the substance abuse. As a result of that, comorbid Axis I and /or Axis II disorders might be judged as being part of the substance abuse. In practice, the intake procedure should be extended with measuring instruments that focus on comorbid Axis I or Axis II disorders. In treatment of younger clients, it is recommended to focus on possible problems related to education or work.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:http://purl.utwente.nl/essays/63344
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