Psychiatric Quarterly, Vol. 72, No. 1, 2001
OLDER ADULT PATIENTS WITH BOTH
PSYCHIATRIC AND SUBSTANCE ABUSE
DISORDERS: PREVALENCE AND HEALTH
Holly G. Prigerson, Ph.D., Rani A. Desai, Ph.D., and
Robert A. Rosenheck, M.D.
The prevalence and service use among older adults with concurrent psychiat-
ric and substance abuse disorders (the ‘‘dually diagnosed’’) was examined in
a cross-sectional survey of a representative national sample of Department of
Veterans Affairs mental health program patients (N ϭ 91,752). Rates of dual
diagnosis declined signiﬁcantly (P ϭ 0.001) as the age of the respondents
increased (26.7% of patients Ͻ 65 years; 6.9% of patients Ն 65 years). Dually
diagnosed older adult patients had longer inpatient 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 less common among older compared
to younger patients, although their heavy use of certain (particularly, outpa-
tient psychiatric) services suggests that should more dually diagnosed pa-
tients survive to old age their consumption of some forms of mental health
care is likely to be high.
KEY WORDS: dual diagnosis; health service use; elderly/geriatrics.
From the Mental Illness Research, Education and Clinical Center and the Northeast
Program Evaluation Center, West Haven, CT (Prigerson, Desai, Rosenheck); the De-
partment of Psychiatry, Yale University School of Medicine, New Haven, CT (Priger-
son, Desai, Rosenheck); and the Department of Epidemiology and Public Health, Yale
University School of Medicine, New Haven, CT (Rosenheck).
Address correspondence to Dr. Holly G. Prigerson, Rm. 522 Connecticut Mental
Health Center, 34 Park Street, New Haven, CT 06519; e-mail: Holly.Prigerson@
0033-2720/01/0300-0001$19.50/0 2001 Human Sciences Press, Inc.