Rates and sequelae of the coexistence of substance use and other XXXX .

@entity1 @entity74 @entity146
OBJECTIVES: Despite a growing body of investigations documenting the coexistence of substance use and other @entity146 in a variety of @entity1 populations, no data about comorbidity in the inpatient mental health system in Alaska have been published in scientific journals, and only limited data exist nationwide about coexistence rates in public @entity146 hospitals. METHODS: A retrospective population based study was performed on the entire population of @entity146 @entity1 hospitalized at Alaska Psychiatric Institute (API) between 1993 and 2001. To explore rates of comorbidity, 5,862 @entity1 (who accrued 10,656 visits) were classified according to their diagnostic status; to explore clinical and socio-demographic difference between @entity1 with and without @entity74 , univariate analyses were calculated. RESULTS: The study revealed startlingly high rates of comorbidity that have been rising steadily since the early 1990's. In fact, comorbidity has become the rule, not the exception, among @entity1 receiving services at API, with over 60% presenting with coexisting substance use symptoms. Complicating issues even further, these comorbid @entity1 presented with more complex social and interpersonal circumstances, more complex clinical issues, different courses of treatment, and greater symptom complexity than @entity146 @entity1 . CONCLUSIONS: 1.) Individual @entity1 level--Providers for @entity146 inpatients must become more prepared to deal with coexisting substance abuse symptoms; policy makers must become more aware of the need for such @entity1 to have smooth transitions from mental health to substance abuse treatment systems. 2.) Systemic-administrative level--Educators must better prepare providers to deal with this challenging clientele.
