Parole chiave
Continuity of Care
Mental Health
Nursing Approach
Transmural Model
Abstract
Introduction. Dual diagnosis, defined as the co-occurrence of a mental health disorder and a substance use disorder, represents a major public health challenge and is associated with poorer prognosis, 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 integration between hospital and community settings. The aim of this study was to retrospectively analyze the clinical and care complexity of patients with dual diagnosis.
Materials and Methods. A retrospective descriptive study was conducted at the Psychiatric Diagnosis and Treatment Unit of the “Madonna del Soccorso” Hospital in San Benedetto del Tronto, Italy. Hospital admissions occurring between June 1, 2021, and June 1, 2025, were analyzed. Data analysis included a descriptive phase and an inferential phase using statistical testing.
Results. Approximately half of the patients experienced repeated hospital admissions, with a mean length of stay of 13.5 days. The most frequent psychiatric diagnoses associated with substance use were personality disorders, psychotic disorders, and mood disorders. Significant impairment in relational and social functioning, together with poor treatment adherence, also emerged. Greater continuity of care and stronger integration between hospital and community services were associated with improved treatment adherence and reduced relapse rates.
Discussion. A multidisciplinary, person-centered approach supported by a transmural model is fundamental in the management of dual diagnosis. Nurses play a central role in promoting individualized interventions, supporting continuity of care, improving clinical outcomes, and reducing stigma.
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