Journal of Dual Diagnosis最新文献

{"title":"Current Practices in the Treatment of Dual Diagnosis: Insights from a Nationwide Survey of Italian Psychiatrists on Pharmacological and Nonpharmacological Approaches, Challenges, and Limitations.","authors":"Stefania Chiappini, Valerio Ricci, Sergio De Filippis, Diego Quattrone, Giovanni Martinotti","doi":"10.1080/15504263.2026.2686094","DOIUrl":"10.1080/15504263.2026.2686094","url":null,"abstract":"<p><p><b>Objective:</b> This study investigated current clinical practices, organizational barriers, and resource availability in managing dual diagnosis (co-occurring psychiatric and substance use disorders) among Italian psychiatrists in a healthcare system characterized by service fragmentation between mental health and addiction care. <b>Methods:</b> A structured, self-administered online questionnaire was distributed nationwide to Italian psychiatrists. The survey covered demographic characteristics; organizational aspects and service collaboration; pharmacological and nonpharmacological approaches; and perceived clinical challenges. Data were analyzed descriptively to identify practice patterns and priority intervention areas. <b>Results:</b> Seventy-nine psychiatrists participated from diverse settings (38% addiction services, 25% community mental health services, 14% hospitals, 15% other facilities). While 78% regularly treated dual diagnosis patients, only 38% reported structured protocols between mental health and addiction services. Collaboration was rated as only partially effective by 44%. Integrated treatment was preferred by 61%. The most commonly prescribed medications included mood stabilizers (94%), atypical antipsychotics (68%), anticraving agents (54%), and antidepressants (37%). For depression, trazodone (32%) and serotonergic antidepressants (25%) were used most. For psychosis, aripiprazole (47%) was predominant. Most clinicians (81%) combined pharmacotherapy with psychosocial interventions. Key barriers included insufficient training (67% highlighted need for specialized clinicians), poor service integration, and diagnostic uncertainty. <b>Conclusions:</b> Significant gaps persist in Italian dual diagnosis care despite clinical awareness. Urgent priorities include routine screening, clinician training, national guideline development, organizational reforms promoting service collaboration, and increased availability of structural resources, which was reported as insufficient by 61% of respondents. These improvements are essential for delivering timely, evidence-based, integrated care to this vulnerable population.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"287-303"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Emotional Avoidance in the Relation Between Posttraumatic Stress Disorder Symptoms and Alcohol Use and Related Harm Amongst Asian American Adults.","authors":"Diana Ho, Dominique N Sheldon, Jewelia J Ferguson, Catherine D Trinh, Ateka A Contractor, Prachi H Bhuptani, Ceren Günsoy, Nicole H Weiss","doi":"10.1080/15504263.2026.2686091","DOIUrl":"10.1080/15504263.2026.2686091","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study was to investigate relations between posttraumatic (PTSD) symptom severity, negative and positive emotional avoidance, and alcohol use and related harm amongst an adult community sample of Asian Americans.</p><p><strong>Methods: </strong>An adult sample of Asian Americans (<i>N</i> = 105, 67.6% women) participated in a study examining emotional experiences, including negative and positive emotional avoidance, PTSD symptom severity, and alcohol use and related harm, across different racial and ethnic groups.</p><p><strong>Results: </strong>There was a significant indirect effect of PTSD symptom severity on alcohol use and related harm through the pathway of positive (<i>β</i> = -0.02, 95% CI [-0.10, 0.02]), but not negative emotional avoidance (<i>β</i> = 0.10, 95% CI [0.02, 0.19]).</p><p><strong>Conclusions: </strong>The current study builds upon emerging evidence for the critical role of positive emotional experiences in the co-occurrence of PTSD and alcohol use and related harm in an underrepresented population of Asian Americans. Findings suggest that amongst Asian Americans, positive emotional avoidance may play a key role in the association between PTSD and alcohol use and related harm. Thus, it may be beneficial to address positive emotional avoidance in interventions aimed at reducing alcohol use and related harm amongst Asian Americans experiencing PTSD symptoms.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"214-225"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Mental Health, Risk Behaviors, and Social Determinants Among Anabolic-Androgenic Steroid Consumers With and Without Co-occurring Methamphetamine Use in Australia.","authors":"Benjamin Bonenti, Nicholas Kerswell, Grace Shuttleworth, Georgia Murphy, Anthony Barnett, Bahareh Ahmadinejad, Timothy Piatkowski","doi":"10.1080/15504263.2026.2686090","DOIUrl":"10.1080/15504263.2026.2686090","url":null,"abstract":"<p><p><b>Objective</b>: People who use anabolic-androgenic steroids (AAS) frequently engage in polypharmacy, with evidence highlighting recurrent co-use with amphetamine-like stimulants. While the independent risks of each substance are established, little is known about their combined impact in treatment-engaged populations. This study compared people who co-use AAS with methamphetamine (AAS-M) and without (AAS-non-meth [AAS-NM]) across mental health, risk behaviors, and social determinants. <b>Methods</b>: Intake data were drawn from Lives Lived Well (LLW), a large Australian non-government alcohol and other drug (AOD) service provider. Clients attending any LLW service Australia-wide between 1 November 2022 and 28 February 2025 reporting past three-month AAS use on the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (WHO-ASSIST) formed the analytic sample (<i>N</i> = 517). The sample was stratified into AAS-M (<i>n</i> = 429) and AAS-NM (<i>n</i> = 88) groups. Group differences in social, structural, and quality of life indicators were tested using <i>χ²</i> and independent samples <i>t</i>-tests. <b>Results</b>: Compared to the AAS-NM group, clients in the AAS-M group were significantly more likely to report trauma, psychosis, and driving under the influence, with higher impulsivity scores on negative urgency, positive urgency, and sensation seeking (<i>χ²</i> and <i>t</i>-tests, all <i>p</i> < .05; <i>ϕ</i> = .10-.12, <i>d</i> = -0.29 to -0.37). They also showed greater engagement in unsafe injecting and recent overdose (<i>χ²</i>, both <i>p</i> < .05). Social vulnerabilities were more pronounced, including elevated risks of homelessness, eviction, and recent violence (<i>χ²</i>, all <i>p</i> ≤ .01; <i>ϕ</i> = .11-.19). Finally, loneliness indicators were significantly higher among AAS-M clients (<i>t</i>-tests, both <i>p</i> < .01; <i>d</i> = -0.31 to -0.32). <b>Conclusions</b>: Co-use of AAS and methamphetamine among AOD service-engaged individuals is linked to heightened mental health concerns, risk behaviors, and social disadvantage. The findings indicate that AAS users who also use methamphetamine experience greater vulnerability than those who do not, underscoring the need for targeted responses within Australian treatment services.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"226-235"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Related Stress, Impulsivity, and Alcohol Use Outcomes among College Students.","authors":"Ian A Mcnamara, Natalia Jaume-Feliciosi, Belal Jamil, Chelsie E Benca-Bachman, Rohan H C Palmer, Jinni Su","doi":"10.1080/15504263.2026.2638196","DOIUrl":"10.1080/15504263.2026.2638196","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the associations between COVID-19 related stress and alcohol use outcomes, and the role of impulsive personality traits in moderating these associations.</p><p><strong>Participants: </strong>Participants were college students from a large public university in the southwestern United States (<i>n =</i> 425; 74.9% female) and a private mid-size institution in the southeastern United States (<i>N =</i> 114; 74.6% female).</p><p><strong>Methods: </strong>Students completed self-report assessments during fall 2020. Hierarchical multiple regression models were conducted.</p><p><strong>Results: </strong>Main effects of COVID-19 related stress, negative urgency, and sensation seeking on both alcohol consumption and alcohol use disorder (AUD) symptoms emerged. The association between COVID-19 related stress and AUD symptoms was greater among students with higher negative urgency.</p><p><strong>Conclusions: </strong>The association between COVID-19 related stress and drinking is evident across the undergraduate student body. Findings demonstrate that students higher in negative urgency may be particularly vulnerable to AUD pathology during periods of heightened stress.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"108-122"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Stigma Patterns in Cannabis-Induced Versus Non-Cannabis-Induced First-Episode Psychosis.","authors":"Valerio Ricci, Giuseppe Maina","doi":"10.1080/15504263.2026.2638185","DOIUrl":"10.1080/15504263.2026.2638185","url":null,"abstract":"<p><strong>Objective: </strong>This study examined differences in self-stigma between patients with cannabis-induced first-episode psychosis (C-FEP, <i>n</i> = 10) and non-cannabis-induced first-episode psychosis (NC-FEP, <i>n</i> = 10).</p><p><strong>Methods: </strong>We used three core measures: the Self-Stigma of Mental Illness Scale (SSMIS), the Rosenberg Self-Esteem Scale (RSES), and qualitative interviews.</p><p><strong>Results: </strong>Despite similar levels of stereotype awareness, C-FEP patients showed significantly lower stereotype concurrence (<i>p</i> < .01) and self-application (<i>p</i> < .05) than NC-FEP patients. C-FEP patients attributed their symptoms to cannabis use rather than inherent vulnerability, potentially buffering against internalized stigma, but expressed greater disclosure concerns. Self-esteem was higher in the C-FEP group (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>These findings suggest that causal attribution influences self-stigma manifestation, with important implications for tailored stigma interventions in early psychosis.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"101-107"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic Stress and Drug Use-Related Harm: Ethnic-Racial Identity as a Moderator for Women of Color Enduring Partner Violence.","authors":"Jewelia J Ferguson, Emmanuel D Thomas, Diana Ho, Noam G Newberger, Nicole H Weiss","doi":"10.1080/15504263.2026.2638187","DOIUrl":"10.1080/15504263.2026.2638187","url":null,"abstract":"<p><strong>Objective: </strong>Intimate partner violence is highly prevalent, with approximately one in two women reporting experiences of intimate partner violence (IPV) at some point in their lifetime. Posttraumatic stress disorder (PTSD) is etiologically tied to trauma-including experiences of IPV-and is associated with drug use-related harm. Women of color experience higher rates of IPV, PTSD, and drug use-related harm compared to their white counterparts; however, a dearth of research has been conducted on the relation between PTSD symptoms and drug use-related harm among women of color experiencing IPV. Moreover, little research has identified factors that may ameliorate the association between PTSD symptoms and drug use-related harm. To advance this research, this study investigated the role of ethnic-racial identity as a moderator in the relation between PTSD symptoms and drug use-related harm.</p><p><strong>Method: </strong>Participants were 103 women of color currently experiencing IPV who were recruited from the community. Regression analyses examined whether ethnic-racial identity facets of affirmation, exploration, and resolution attenuated the relation between PTSD symptoms and drug use-related harm.</p><p><strong>Results: </strong>The affirmation component of ethnic-racial identity moderated the relation between PTSD symptoms and drug use-related harm (<i>B</i> = -0.02, <i>p</i> = .02), such that PTSD symptoms were significantly associated with drug use-related harm at higher (<i>b</i> = 0.10, <i>p</i> < .001), but not lower (<i>b</i> = 0.01, <i>p</i> = .52), levels of ethnic-racial identity affirmation. No moderating effects were detected for ethnic-racial identity exploration and resolution.</p><p><strong>Conclusion: </strong>Results of this study suggest that bolstering the ethnic-racial identity facet of affirmation among women of color who experience IPV may attenuate the relation between PTSD symptoms and drug use-related harm.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"81-92"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Anxiety Sensitivity and Smoking Constructs in Black Adults With Obesity Who Smoke.","authors":"Brooke Y Redmond, Lindsay M Bevers, Justin M Shepherd, Duckhyun Jo, Michael J Zvolensky","doi":"10.1080/15504263.2026.2638188","DOIUrl":"10.1080/15504263.2026.2638188","url":null,"abstract":"<p><strong>Objective: </strong>Black individuals in the United States have high rates of obesity and cigarette smoking, both of which increase health risks. One factor that has demonstrated significant relations to cigarette smoking outcomes is anxiety sensitivity. Yet, work examining these relations among Black individuals with obesity who smoke is nonexistent. Therefore, the present study examined the role of anxiety sensitivity in relation to several smoking outcomes among Black individuals with obesity who smoke.</p><p><strong>Methods: </strong>Participants were 161 Black adults with obesity who endorsed daily combustible cigarette smoking (<i>M</i>_age = 47.1 years, <i>SD</i> = 14.19, age range 19-73 years; 65.2% female).</p><p><strong>Results: </strong>Results indicated that greater levels of anxiety sensitivity were statistically significantly and positively related to increased cigarette dependence, severity of problems when trying to quit, perceived barriers to smoking cessation, and smoking abstinence expectancies, including negative mood, somatic symptoms, and harmful consequences. Importantly, findings were observed above and beyond the variance accounted for by age, sex, education, income, perceived physical health, average number of cigarettes smoked per day, hazardous drinking, and cannabis use.</p><p><strong>Conclusions: </strong>These findings suggest that Black individuals with obesity who smoke and exhibit higher levels of anxiety sensitivity may be at increased risk for processes known to sustain smoking behavior and impede quitting success.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"136-147"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work-Related Conversational Skills Training for People with Substance Use Disorders.","authors":"Tameika Minor, Janice Oursler, Weili Lu, Samantha J Herrick, John Beninato, Ni Gao, Abigail Malbrough, Esther Lo, Gabrielle Drake, Vrinda Sheth, Bianca Colon, Shannon Ettinger, SunHee Eissenstat","doi":"10.1080/15504263.2026.2638189","DOIUrl":"10.1080/15504263.2026.2638189","url":null,"abstract":"<p><strong>Objective: </strong>There are high rates of unemployment among individuals with substance use disorders (SUDs) and unemployment can increase the risk of relapse. Additionally, SUD relapse can increase the chance of job loss. However, there is a dearth of research related to the feasibility and acceptability of employment counseling strategies for individuals with SUDs.</p><p><strong>Methods: </strong>This study is a secondary sub-group analysis of data attained from a pre-post trial (no control group) of the Conversing with Others intervention, a direct skills teaching (DST) approach designed to enhance confidence with workplace conversational skills. The brief, small-group intervention was administered to 68 participants with SUDs among which 43 (63.2%) had dual diagnoses in community agency settings.</p><p><strong>Results: </strong>From pre- to post-intervention, participants reported greater confidence with and increased knowledge of having a conversation with others in the workplace. Furthermore, participants reported high levels of overall satisfaction with the quality of the intervention.</p><p><strong>Conclusions: </strong>Securing employment can positively impact the lives of people with SUDs and foster recovery. Brief, targeted soft skills training for enhancing workplace conversational confidence and knowledge may be feasible and acceptable to implement among individuals with SUDs and dual diagnoses in community settings. Findings also have implications for mental health practitioners, multidisciplinary practice, policy makers, and researchers.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"123-135"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Effects of Buprenorphine Treatment on Depression Symptoms Among Adults with Opioid Use Disorder: A Scoping Review.","authors":"Victoria R Votaw, Rachel L Rosen, Andrew D Peckham, Zoe London, Lisa L Philpotts, Roger D Weiss, R Kathryn McHugh, Joanna M Streck","doi":"10.1080/15504263.2026.2638194","DOIUrl":"10.1080/15504263.2026.2638194","url":null,"abstract":"<p><strong>Objective: </strong>More than one-third of adults with opioid use disorder (OUD) have co-occurring major depressive disorder. Yet existing antidepressant pharmacotherapies have shown limited efficacy in this population. Emerging evidence suggests that buprenorphine treatment may reduce depression symptoms among those without OUD, but there is a need to better understand the impacts of buprenorphine on depression symptoms in those with OUD. We conducted a scoping review of the literature exploring the effect of buprenorphine treatment on depression symptoms among adults with OUD.</p><p><strong>Methods: </strong>Online databases (e.g., PubMed) were used to identify papers published through September 2024 following PRISMA-ScR guidelines. We included 48 full-text articles from 36 unique studies that included a depression outcome at ≥ 2 time points in adults receiving buprenorphine for OUD treatment.</p><p><strong>Results: </strong>Mean depression scores at baseline (largely before initiation) were generally above clinical cutoffs and reduced with buprenorphine treatment. In most cases, depression symptoms rapidly decreased upon buprenorphine initiation. Yet a subgroup of patients (20-37%) receiving buprenorphine appears to experience persistent depression symptoms.</p><p><strong>Conclusions: </strong>Most individuals with OUD treated with buprenorphine experienced rapid decreases in depression symptoms upon treatment initiation. However, most studies included in the review were not designed to assess the effect of buprenorphine on depression symptoms. Challenges to synthesizing and interpreting study results included small sample sizes, suboptimal measures of depression symptoms and assessment schedules, and widespread exclusion of higher severity subgroups (e.g., individuals with suicidal ideation) in included studies. Future work is needed to explore the mechanisms underlying the antidepressant effects of buprenorphine in people with OUD and to investigate optimal antidepressant treatments for patients who experience persistent depression during buprenorphine treatment.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"158-190"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid And In-Person Care for Dual Diagnosis Patients: Utilization Patterns and Impact on Dropout Across COVID-19 Public Health Periods.","authors":"Marta Narváez-Camargo, Cinta Mancheño-Velasco, Carmen Díaz-Batanero, Fermín Fernández-Calderón, Esperanza Vergara-Moragues, Óscar M Lozano","doi":"10.1080/15504263.2026.2638190","DOIUrl":"10.1080/15504263.2026.2638190","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prompted a rapid expansion of telehealth services in patients with substance use disorders (SUD) and comorbid mental health conditions (dual diagnosis). However, evidence on the effectiveness and utilization of hybrid care (combining in-person and telehealth modalities) in this population remains limited.</p><p><strong>Objective: </strong>This study aims to analyze the use of a hybrid treatment (telehealth and in-person treatment) among patients with dual pathology across three distinct periods-before, during, and after COVID-19-related public health measures-and to assess the impact of hybrid care on treatment dropout rates.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using electronic health records (EHR) from 6,365 outpatients diagnosed with SUD and comorbid mental disorders, between March 2018 and September 2023. Patients were classified by treatment modality (in-person vs. hybrid) and period of care. Bivariate statistics and Cox regression analyses were performed to identify predictors of treatment dropout, accounting for demographic and clinical variables.</p><p><strong>Results: </strong>Hybrid care utilization increased significantly during the pandemic and remained elevated post-pandemic. Women and patients with opioid use disorder were more likely to receive hybrid care. Patients receiving hybrid therapy had significantly lower dropout rates and longer treatment durations. Also, patients in coordinated care (addiction and mental health centers) show lower rates of dropout. Cox regression confirmed that hybrid care was the strongest predictor of reduced treatment dropout across all periods.</p><p><strong>Conclusions: </strong>Hybrid care models enhance treatment retention among dual diagnosis patients, underscoring the need to maintain and optimize telehealth options for this high-risk group even beyond pandemic-related restrictions.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"148-157"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}