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Exploring the diversity of dual diagnosis: Utility of cluster analysis for program planning

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Abstract

This study demonstrates the utility of using cluster analysis to explore the heterogeneity of dual diagnosis populations so as to facilitate planning and implementation of individualized treatment programs. A sample of 467 persons admitted to a state psychiatric hospital with DSM-III-R psychiatric diagnoses and substance abuse problems were interviewed on the Addiction Severity Index (ASI) and other measures to assess psychological, social, and community functioning. Scores on seven ASI severity ratings (medical, employment, alcohol, drug, legal, family, and psychiatric functioning) were used to group patients into seven homogeneous subgroups using cluster analysis: best functioning, unhealthy alcohol abuse, functioning alcohol abuse, drug abuse, functioning polyabuse, criminal polyabuse, and unhealthy polyabuse. Cluster reliability and validity were demonstrated using split-half tests as well as cross-sectional and longitudinal analyses. Results illustrate the extreme heterogeneity of dual diagnosis and are suggestive of how individualized treatment programs can be matched to the particular needs of patients with dual diagnoses.

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Authors and Affiliations

  1. Saint Louis University School of Public Health, 3663 Lindell Blvd., 63108-3342, St. Louis, MO

    Douglas A. Luke Ph.D. (Assistant Professor of Community Health)

  2. School of Social Work, University of Michigan, Michigan, USA

    Carol T. Mowbray Ph.D. (an associate professor)

  3. Department of Psychology, University of Minnesota, Minnesota, USA

    Kelly Klump B.A. (a graduate student)

  4. Michigan Department of Community Health, Lansing

    Sandra E. Herman Ph.D. (program evaluator)

  5. Department of Veterans Affairs, Ann Arbor, MI

    Bonnie BootsMiller Ph.D. (a research fellow)

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  1. Douglas A. Luke Ph.D.
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  2. Carol T. Mowbray Ph.D.
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  3. Kelly Klump B.A.
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  4. Sandra E. Herman Ph.D.
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  5. Bonnie BootsMiller Ph.D.
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Additional information

Support for this research came from a National Institute of Mental Health grant (MH46307-03) awarded to the Michigan Department of Mental Health. This project is a collaborative effort among the Michigan Department of Mental Health, Detroit-Wayne County Community Mental Health Board, Northville Regional Psychiatric Hospital, Michigan State University, and Wayne State University.

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Luke, D.A., Mowbray, C.T., Klump, K. et al. Exploring the diversity of dual diagnosis: Utility of cluster analysis for program planning. The Journal of Mental Health Administration 23, 298–316 (1996). https://doi.org/10.1007/BF02522304

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