Influence of mental comorbidity on the level of rehabilitation potential of juvenile patients in a drug treatment clinic

Background. The relationship between self-injurious, suicidal behavior and the use of psychoactive substances (PAS) is discussed in the literature. Problematic behavior with substance use may be a sign of more complex psychiatric problems, which affects the curability and compliance of patients. Objective: to study the influence of mental comorbidity on the level of rehabilitation potential (LRP) in minors admitted for treatment in the narcological department. Material and Methods. The study was carried out on the basis of the juvenile department of the Chelyabinsk Regional Clinical Narcological Hospital. A continuous study included patients (n=168, 127 males and 41 females) aged 12-17 years (mean age 15.4±0.1 years) diagnosed with substance dependence syndrome (ICD-10 codes F10.2-F19.2). 2 groups of patients were formed according to the presence/absence of a comorbid mental disorder: group 1, main (n=79; 47%) - dual diagnosis, a combination of narcological pathology and mental disorders; the 2nd group, comparisons (n=89; 53%) - drug diagnosis without mental disorders. The definition of LRP was carried out in 4 blocks: pre-morbid, clinical signs of the disease, features of social status and social consequences, personality changes. Results. In a continuous sample of people with addiction syndrome, comorbid mental disorders occur in 47% (separated into the main group, n=79): the syndrome of dependence on substances not classified as drugs (83%), including alcohol, prevailed (29%), patients were younger (15.1±0.1 years versus 15.7±0.1 years in the comparison group, n=89); organic mental disorders were in the lead in terms of frequency (63%), mental retardation (19%) and disorders of emotions and behavior with onset in childhood or adolescence (19%) were less frequently diagnosed. LRP in such patients was significantly lower, the most unfavorable profile of mental comorbidity was registered with mental retardation.