Keywords
Transmural model
Nursing approach
Mental health
Continuity of care
Abstract
ABSTRACT
INTRODUCTION: Dual diagnosis, defined as the co-occurrence of a mental health disorder and a substance use disorder, represents one of the major challenges for public health, associated with poor prognoses, increased relapse rates and greater complexity of care. Scientific evidence indicates that approximately 50% of patients with one of these conditions also develop the other. In this context, nursing management requires a comprehensive and multidisciplinary approach, focused on continuity of care and seamless handover between hospital and community settings. The aim of this study is to retrospectively analyse the clinical and care complexity of patients with dual diagnosis.
MATERIALS AND METHODS: A retrospective descriptive study was conducted at the Operational Unit of the Psychiatric Diagnosis and Treatment Service of the “Madonna del Soccorso” Hospital in San Benedetto del Tronto, considering admissions from 1 June 2021 to 1 June 2025. Data analysis involved a descriptive phase and an inferential phase using paired t-tests.
RESULTS: The results show that approximately half of the patients have repeated admissions, with an average length of stay of 13.5 days. The most frequent diagnoses associated with substance use are personality disorders (42%), psychotic disorders (33%) and mood disorders (14%). Significant impairments in relational and social functioning, as well as poor treatment adherence, are also evident. However, continuity of care and integration between hospital and community services are associated with greater adherence to treatment and a reduction in relapse rates.
DISCUSSION: A multidisciplinary, person-centred approach supported by a transmural model is fundamental to the management of dual diagnosis, and the role of the nurse is central to promoting personalised interventions, improving clinical outcomes and combating stigma.
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