ABSTRACT

This chapter proposes that the term co-morbidity will be used throughout and one diagnosis will be drug misuse. In terms of an individual patient’s history, one condition occurs first. In the case of an initial substance misuse problem, intoxication, withdrawal, or chronic effects with or without continued drug use, can lead to psychiatric complications and long term ‘co-morbidity’ issues. A group assessed was the homeless population, and this showed near 30 per cent prevalence of drug misuse, again typically cannabis, but also opiates along with benzodiazepines. Co-morbidity in this sample was about 15 per cent. When compared with mental health patients who are severely mentally ill, patients with co-morbidity were found to be younger, have increased feelings of anger, more involvement with the criminal justice system and more suicidal threats. In the heterogeneous group of co-morbidity, P. Lehman and colleagues have tried to define sub-groups for service planning. Four of these groups warrant further definition.