Older adult patients with both psychiatric and substance abuse disorders: Prevalence and health service use

The prevalence and service use among older adults with concurrent psychiatr ic and substance abuse disorders (the "dually diagnosed") was examined in a cross-sectional survey of a representative national sample of Department o f Veterans Affairs mental health program patients (N = 91,752). Rates of du al diagnosis declined significantly (P = 0.0011 as the age of the responden ts increased (26.7% of patients ( 65 years; 6.9% of patients greater than o r equal to 65 years). Dually diagnosed older adult patients had longer inpa tient stays for substance abuse and more outpatient substance abuse visits than did non-dually diagnosed elderly patients, and more outpatient general psychiatric visits than all the contrast groups. Dual diagnosis appears le ss common among older compared to younger patients, although their heavy us e of certain (particularly, outpatient psychiatric) services suggests that should more dually diagnosed patients survive to old age their consumption of some forms of mental health care is likely to be high.