Italy has two different public healthcare services taking in care patients with dual diagnosis: (1) the mental health services (Centri di Salute Mentale - CSM) and (2) and the drug abuse services (Servizi per le Dipendenze - Ser.D.). We collected and analyzed data regarding the frequency of the co-morbidities in Veneto Region during 2019. Our study shows that only the 1% of the patients in treatment in the mental health services and the 8.7% of those in drug abuse services are recognized as dual diagnosed subjects. In drug abuse services the most frequent substance use disorders (SUD) correlated with a psychiatric disease were the alcohol and opioids use disorders, while the most prevalent psychiatric disorders associated with a SUD were the personality disorders and the schizophrenia, schizotypal and delusional disorders. Our data indicate that the diagnosis of co-morbidity should be improved in both services and that integrated programs between the above services should be developed to improve the best practices.

Hepatitis D virus (HDV) is a public health concern for its severe medical consequences. The aim of this pilot study was to evaluate the prevalence of the main infectious disease between the detainees of the Veneto Region. The study consisted of a survey carried between the heads of the prison healthcare staff. The data showed that on 2,119 detainees the prevalence of hepatitis B (HBV) is the 6% and that the most relevant prevalence of HBV was revealed in the East Europe detainees (Ex USSR countries, Albania, Bosnia, Kosovo, Macedonia), being the 39% of all HBcAb positive subjects. The survey also revealed as the population less protected by HVB vaccination was that comes from East Europe. Moreover, the study indicates that hepatitis D diagnosis is not well known by clinician working inside prisons and that it should be improved through specific diagnostic and therapeutic procedures. Our data indicate that the prison setting may play an important and crucial role in term of public health both in intercepting patients that need of treatment and in preventing actions able to minimize the risk of infection. In prison settings screening, linkage to care and harm reduction measures should be improved in order to protect the general population from the impact of the emerging infectious diseases, including HDV.

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