Protocols of Dual Diagnosis Intervention in Schizophrenia

Abstract

Objective:To review the existing literature on the psychopharmacological and psychotherapeutic treatment of patients with both schizophrenia and a substance use disorder (SUD).

Characterizing the longitudinal patterns of substance use among individuals diagnosed with serious mental illness after psychiatric hospitalization

“…Thus, our findings suggest characterizing the factors associated with poor outcomes may be critical to facilitating effective treatments for substance abuse in this population. Indeed, there is a diagnostic dilemma in terms of whether SMI is associated with primary or induced SUD [36, 55–63], and thus an accurate psychiatric diagnosis is a key component of substance use treatment planning [36]. Delivering treatments for substance abuse presents challenges for mental health professionals [64], and there is seemingly no consensus on a recommended model of intervention to follow in these patients [36], although models employing integrated treatment for co-occurring disorders have a solid evidence base [68–69].…”

“…Indeed, there is a diagnostic dilemma in terms of whether SMI is associated with primary or induced SUD [36, 55–63], and thus an accurate psychiatric diagnosis is a key component of substance use treatment planning [36]. Delivering treatments for substance abuse presents challenges for mental health professionals [64], and there is seemingly no consensus on a recommended model of intervention to follow in these patients [36], although models employing integrated treatment for co-occurring disorders have a solid evidence base [68–69]. Regardless, the preponderance of the evidence indicates combinations of psychotherapies, behavioral and pharmacological interventions offer effective treatments for this population [65], but how these should be applied in light of such heterogeneity in substance use problems is not well-established.…”

“…Regardless, the preponderance of the evidence indicates combinations of psychotherapies, behavioral and pharmacological interventions offer effective treatments for this population [65], but how these should be applied in light of such heterogeneity in substance use problems is not well-established. Recent reports suggest that the intensity of substance abuse treatment should be commensurate with the severity of SMI [65], and advise implementing the integrated model due to the favorable results achieved [66, 36]. The integrated model assumes that the patient is cared for by a single team [66–67], and since it already targets the impact of substance use on psychiatric symptomology [66–67], these programs are adaptable to account for sub-group characteristics in terms of treatment needs.…”

“…Although previous research has identified characteristics that influence the recovery of persons with SMIs, improving outcomes is challenging [33, 36], and thus an investigation comparing the patterns of drug and alcohol use over time across patients with schizophrenia-spectrum, bipolar and depressive disorders is important. The present study sought to prospectively examine the longitudinal patterns of substance use in terms of recovery across a large and diverse sample of psychiatric patients.…”

Professionals’ perceptions about healthcare resources for co-occuring disorders in Spain

“…Indeed, integrated services for dually diagnosed patients pathology face continuous challenges to find more efficient and effective strategies for improving the overall poor prognosis and outcomes and the rates of morbidity and mortality associated with this condition [8, 10, 13, 16, 21, 28, 30, 31]. …”