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This prospective multi-centre study was designed to describe and compare co-morbidity, service use of and service provision for patients with dual diagnosis (mental illness combined with substance abuse) in seven European psychiatric settings. Further more clinical and social outcomes will be analysed, risk factors/predictors of prognosis will be described with specific focus on gender and an educational programme for staff dealing with these patients will be developed and disseminated on an European basis.


To achieve these goals a combination (triangulation) of methods will be used: A cohort study (7x50 patients) with 3,6 and 9 month follow up. A case study (7x4 patients) with follow-up. Focus group interviews exploring patients, relatives and staffs views on the adequacy of service provision and an instrument named TODD for mapping service provision and patients pathways through the system. Finally epidemiological data are gathered at each setting on a local, regional and national basis.


The project work plan falls in seven parts – each centre being responsible for one part.

Keywords; dual diagnosis  / service provision / educational programme / gender

ISADORA Publications

Charzynska K, Hyldager E, Baldacchino A, Greacen T, Henderson Z, Laijarvi H, Hodges CL, Lack C, Sieroslawski J, Baeck- Moller K. (2011) Comorbidity patterns in dual diagnosis across seven European sites. European Journal of Psychiatry, 2012, 25 (4), 179- 191.

Greacen T, Baldacchino A , Charzynska K, Sorsa M, Groussard-Escaffre N, Clancy C , Lack C, Hyldager E, Hodges CL; Merinder LB., Meder J, Henderson Z, Laijarvi H, Baeck-Moller K; Pathways through care for people with dual diagnosis in Europe: results from the Treatment Options for Dual Diagnosis (TODD) User Zoom Instrument, Mental Health and Substance Use: dual diagnosis. 2011, 4,  

Baldacchino A , Greacen T , Hodges C-L , Charzynska K, Sorsa M , Saias T, Clancy C, Lack C Merinder LB , Meder J, Henderson Z, Laijarvi H , Baeck-Moller K , Hyldager E, . Nature, level and type of networking for individuals with dual diagnosis: a European perspective. Drugs: education, prevention and policy: 2011, 18, 5  

Sorsa MGreacen TLehto JÅstedt-Kurki P.  A Qualitative Study of Barriers to Care for People With Co-Occurring Disorders.  Arch Psychiatr Nurs. 2017 Aug;31(4):399-406. doi: 10.1016/j.apnu.2017.04.013. Epub 2017 Apr 23.

Last updated: 01.08.2013

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