Dual Diagnosis, Double Trouble
Introduction Many individuals with severe mental illness (SMI) have substance use disorder comorbidity. Dual diagnosis makes the approach and management of these patients even more challenging since the lack of improvement in either pathologies can lead to a deterioration of both. Objectives To il...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382201197X/type/journal_article |
| _version_ | 1797616802682896384 |
|---|---|
| author | J. Lopes R. Freitas |
| author_facet | J. Lopes R. Freitas |
| author_sort | J. Lopes |
| collection | DOAJ |
| description |
Introduction
Many individuals with severe mental illness (SMI) have substance use disorder comorbidity. Dual diagnosis makes the approach and management of these patients even more challenging since the lack of improvement in either pathologies can lead to a deterioration of both.
Objectives
To illustrate, through the presentation of two cases, the clinical challenges in managing a patient with dual diagnosis
Methods
Clinical case presentation through retrospective review of clinical notes and non-systematic literature review on this topic
Results
We present the clinical cases of two women diagnosed with Bipolar Disorder and (poly)Substance Use Disorder since adolescence, who have a history of multiple hospitalizations due to mostly maniform symptoms. The complexity of case management is evident, both at the pharmacological level and in psychosocial intervention. This is aggravated by the difficulty in maintaining adherence to the therapeutic project and frequent relapses.
Conclusions
Current evidence points to the beneficial effect of a combined pharmacological and psychosocial approach, which must be comprehensive, individualized and require differentiation at various levels that are difficult to achieve and make the treatment of these situations an even greater challenge.
Using illustrative examples, this review draws attention to the practical difficulties in managing situations where substance use is associated with SMI.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:46:34Z |
| format | Article |
| id | doaj.art-a3eb6c7f6c7a481f9b5281e4b7acd3c4 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:46:34Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-a3eb6c7f6c7a481f9b5281e4b7acd3c42023-11-17T05:07:35ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S471S47110.1192/j.eurpsy.2022.1197Dual Diagnosis, Double TroubleJ. Lopes0R. Freitas1Hospital Espirito Santo, Departamento De Psiquiatria E Saude Mental, Evora, PortugalHospital Espirito Santo, Departamento De Psiquiatria E Saude Mental, Evora, Portugal Introduction Many individuals with severe mental illness (SMI) have substance use disorder comorbidity. Dual diagnosis makes the approach and management of these patients even more challenging since the lack of improvement in either pathologies can lead to a deterioration of both. Objectives To illustrate, through the presentation of two cases, the clinical challenges in managing a patient with dual diagnosis Methods Clinical case presentation through retrospective review of clinical notes and non-systematic literature review on this topic Results We present the clinical cases of two women diagnosed with Bipolar Disorder and (poly)Substance Use Disorder since adolescence, who have a history of multiple hospitalizations due to mostly maniform symptoms. The complexity of case management is evident, both at the pharmacological level and in psychosocial intervention. This is aggravated by the difficulty in maintaining adherence to the therapeutic project and frequent relapses. Conclusions Current evidence points to the beneficial effect of a combined pharmacological and psychosocial approach, which must be comprehensive, individualized and require differentiation at various levels that are difficult to achieve and make the treatment of these situations an even greater challenge. Using illustrative examples, this review draws attention to the practical difficulties in managing situations where substance use is associated with SMI. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S092493382201197X/type/journal_articlesubstance abusecomorbiditydual diagnosis |
| spellingShingle | J. Lopes R. Freitas Dual Diagnosis, Double Trouble European Psychiatry substance abuse comorbidity dual diagnosis |
| title | Dual Diagnosis, Double Trouble |
| title_full | Dual Diagnosis, Double Trouble |
| title_fullStr | Dual Diagnosis, Double Trouble |
| title_full_unstemmed | Dual Diagnosis, Double Trouble |
| title_short | Dual Diagnosis, Double Trouble |
| title_sort | dual diagnosis double trouble |
| topic | substance abuse comorbidity dual diagnosis |
| url | https://www.cambridge.org/core/product/identifier/S092493382201197X/type/journal_article |
| work_keys_str_mv | AT jlopes dualdiagnosisdoubletrouble AT rfreitas dualdiagnosisdoubletrouble |