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Disabil Rehabil. 2018 Sep 5:1-7. doi: 10.1080/09638288.2018.1493543. [Epub ahead of print]

Identifying psychosocial difficulties of inpatients with substance use disorders: evaluation of the usefulness of the PARADISE24 for clinical practise.

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a A-Clinic Foundation , Helsinki , Finland.
b Department of Psychiatry , Hyvinkää Hospital Area, Hospital District of Helsinki and Uusimaa , Finland.
c Department of Psychiatry, School of Medicine , Universidad Autónoma de Madrid , Spain.
d National Institute of Health Carlos III , CIBER of Mental Health (CIBERSAM) , Madrid , Spain.



Improvements in overall functioning and well-being are important goals in the treatment of substance use disorders. The aim of the current study was to evaluate the usefulness of the PARADISE24 instrument for studying the scope and severity of psychosocial difficulties by comparing the results with other measures in the context of substance use disorders.


This cross-sectional study included two independent inpatient samples. The first sample consisted of 80 interviews including the PARADISE24 and 10 other measures. The second sample consisted of the responses of 1082 inpatients to a self-administered PARADISE24 questionnaire.


Inpatients with substance use disorders had experienced a wide range of psychosocial difficulties and the two samples produced similar results. Highest scores were observed for emotional difficulties. The PARADISE24 showed convergent validity with measures of disability and depressive symptoms and discriminant validity with personality traits and environmental factors (i.e., social support and caretaker's empathy). Psychosocial difficulties were inversely associated with quality of life and self-assessed health.


The PARADISE24 provides a wide range of useful information on psychosocial difficulties for clinical work and it can be used as a self-administered questionnaire in the evaluation and treatment of substance use disorders. Implications for rehabilitation Individuals undergoing inpatient treatment for substance use disorders experience various and severe psychosocial difficulties. The PARADISE24 is an evidence-based instrument for assessing the scope and severity of 24 common psychosocial difficulties among neurological and psychiatric disorders. The PARADISE24 also offers a time-efficient method which can be used as a self-administered questionnaire in the context of substance use disorders. Comparison between the PARADISE24 and 10 commonly used measures showed that the PARADISE24 covered a wide variety of clinically relevant issues in one questionnaire.


ICF; PARADISE24; alcohol; dependence; disability evaluation; drugs; psychosocial difficulties; treatment

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