Clinical implications of the co-occurrence of substance use and other psychiatric disorders.

Abstract

The co-occurrence of substance use and psychiatric disorders is the rule rather than the exception in mental health and substance use treatment settings across the United States. Such co-occurrence may call for special assessment and evaluation procedures, modified treatment plans, and specialized follow-up. Treatment of co-occurrence of substance abuse and psychiatric disorders requires more cross-disciplinary collaboration; greater integration of substance use, mental health, and social services treatment approaches; and modifications in the training of care providers.This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Comorbidities of mental and behavioral disorders in chemically dependent patients in different periods of abstinence

“…In other studies it was observed that patients with CMBD, especially those with more severe disorders, may have higher rates of aggression, detention due to illegal acts, suicide, relapses, spending on treatment, re-hospitalizations, longer hospitalization periods and greater medical service use 1 .…”

“…Such effects can remain for some days and disappear, unless these disorders are primary and continue to persist after many weeks of abstinence. For these reasons, it is recommended that a patient's follow-up should occur during a significant time for the diagnosis of other MBD to be reliable, and that this time could be different, depending on the PAS used 1 . A higher frequency of these disorders in Group 1 was observed in the present study, even if such diagnoses were considered to be positive when found throughout a certain period of time, rather than associated with recent PAS use exclusively.…”

“…This could be associated with the fact that patients experiencing a crisis were excluded, due to the difficulty in distinguishing previous psychotic symptoms from psychotic symptoms induced by PAS use or abstinence 1 . Another reason for this could be the fact that patients who have more severe MBD are referred to psychiatric institutions to be hospitalized when it is necessary and they only return to the CAPS-ad for CD treatment after longer periods of abstinence have passed.…”

“…Individuals with SUD associated with comorbidities of MBD (CMBD) had more severe symptoms, reported greater suffering and consequently sought treatment more often, when compared to those without comorbidities. However, patients with CMBD showed poorer adherence to treatment, frequent and faster relapses, a higher occurrence of social problems and decreased treatment compliance 1 .…”

Psychiatric symptomatology among individuals in alcohol detoxification treatment

“…It may be erroneously assumed by providers that the prime goal of detoxification services is the initiation of sustained sobriety, and that comorbid psychiatric symptoms will be relieved on their own, or will significantly diminish, once that objective is achieved. Rather, more positive overall outcomes are likely if treatment plans are designed to help alleviate both the alcohol use disorder and any comorbid psychological symptoms (Brems & Johnson, 1997;Grant et al, 2004). Attention to psychiatric symptoms among individuals in detoxification may greatly enhance their outcomes both with regard to sobriety and mental health, especially if detection is timed at the onset of their stay in detoxification and can thus be considered when additional treatment plans are made.…”