Moving beyond single and dual diagnosis in general practice

doi:10.1136/bmj.326.7388.512

BMJ 2003;326:512-514 ( 8 March )

Editorials

Moving beyond single and dual diagnosis in general practice

Many patients have multiple morbidities, and their needs have to be addressed

The first 150 words of the full text of this article appear below.

The awkward phrase "multiple morbidity" describes the common predicament of the many patients who have more than one healthproblem. Such patients are disproportionately represented amongpopulations that are socioeconomically deprived and elderly.¹A socioeconomic gradient exists in the incidence and prevalenceof almost all major categories of disease, meaning that individualsand families who are socioeconomically disadvantaged are at riskof a compounding multiplicity of health and social problems.²This multiple morbidity, coupled with the fact that the populationof the United Kingdom is ageing,³ poses challenges to the deliveryof effective health care that have received almost no officialattention.

Examples from mental health show that provision of service in this field has been slow to move from single diagnosis to dualdiagnosis.⁴ Dual diagnosis applies to patients who have a mentalhealth problem and problematic substance or alcohol use. A recentreport on dual diagnosis from the . . . [Full text of this article]

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