Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-27T06:17:08.850Z Has data issue: false hasContentIssue false

Chapter 7 - The Inpatient with Dual Diagnosis (Co-Occurring Disorder)

Published online by Cambridge University Press:  05 March 2020

Michael I. Casher
Affiliation:
University of Michigan
Joshua D. Bess
Affiliation:
University of Michigan
Get access

Summary

First, a clarification of vocabulary is needed. In this chapter, the terms “dual diagnosis,” “substance use disorder[s],” “[name of substance] use,” and/or “[name of substance] dependence” are used. The more modern term “co-occurring disorder” is virtually synonymous with “dual diagnosis,” both of which reference the coexistence of a clinically significant use of drugs and/or alcohol with a primary psychiatric illness (an example of this would be bipolar disorder with cocaine dependence). Of course, a patient can have a substance use disorder (SUD) without having a dual diagnosis – i.e., without a separate, primary psychiatric illness [1]. The assumption is made that, unless mentioned specifically, clinical situations discussed here involve patients who do have a primary psychiatric illness in addition to a SUD. Also, although the fairly recent, though now outdated, DSM-IV criteria differentiated between substance abuse and substance dependence, this volume (again, unless specifically mentioned) does not make that distinction.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lehman, A, Myers, C, Corty, E, Thompson, J. Prevalence and patterns of “dual diagnosis” among psychiatric inpatients. Comprehensive Psychiatry 1994;35(2):106–12.Google Scholar
Kelly, J, Westerhoff, C. Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. International Journal of Drug Policy 2010;21(3):202–7.Google Scholar
Compton, WM, Dawson, DA, Goldstein, RB, Grant, BF. Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol. Drug Alcohol Dependence 2013;132(1–2):387–90.Google Scholar
Bulkley, LD. Syphilis occurring in connection with other diseases of the skin. In: Medical Society of the State of New York, ed., Transactions of the Medical Society of the State of New York. Syracuse, NY: The Syracuse Journal Company 1887.Google Scholar
Kessler, R. The epidemiology of dual diagnosis. Biological Psychiatry 2004;56(10): 730–7.CrossRefGoogle ScholarPubMed
Buckley, P, Brown, E. Prevalence and consequences of dual diagnosis. Journal of Clinical Psychiatry 2006;67(7):e01.Google Scholar
Breslow, RE, Klinger, BI, Erickson, BJ. Acute intoxication and substance abuse among patients presenting to a psychiatric emergency service. General Hospital Psychiatry 1996;18(3):183–91.Google Scholar
Budney, A, Hughes, J, Moore, B, Vandrey, R. Review of the validity and significance of cannabis withdrawal syndrome. American Journal of Psychiatry 2004;161(11): 1967–77.Google Scholar
McKeon, A, Frye, M, Delanty, N. The alcohol withdrawal syndrome. British Medical Journal 2008;79(8): 854–62.Google Scholar
Wright, S, Gournay, K, Glorney, E, Thornicroft, G. Dual diagnosis in the suburbs: prevalence, need, and in-patient service use. Social Psychiatry and Psychiatric Epidemiology 2000;35(7):297304.Google Scholar
Mordal, J, Bramness, J, Holm, B, Mørland, J. Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence. General Hospital Psychiatry 2008;30(1):5560.CrossRefGoogle ScholarPubMed
Caton, CL, Drake, RE, Hasin, DS, et al. Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses. Archives of General Psychiatry 2005;62(2):137–45.Google Scholar
Caton, CL, Hasin, DS, Shrout, PE, et al. Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis. British Journal of Psychiatry 2007;190:105–11.Google Scholar
Renner, JA. How to train residents to identify and treat dual diagnosis patients. Biological Psychiatry 2004;56(10):810–16.Google Scholar
Crockford, DFG, Milin, R, Buckley, L, et al. Training in substance-related and addictive disorders, part 2: updated curriculum guidelines. Canadian Journal of Psychiatry 2015;60(12):112.Google Scholar
Ziedonis, D. Integrated treatment of co-occurring mental illness and addiction: clinical intervention, program, and system perspectives. CNS Spectrums 2004;9 (12):892904, 925.Google Scholar
Cornelius, J, Clark, D, Salloum, I, Bukstein, O, Kelly, T. Management of suicidal behavior in alcoholism. Clinical Neuroscience Research 2001;1(5):381–6.Google Scholar
Goldberg, JF, Singer, TM, Garno, JL. Suicidality and substance abuse in affective disorders. Journal of Clinical Psychiatry 2001;62(25):3543.Google Scholar
Duffy, J, Kreitman, N. Risk factors for suicide and undetermined death among in-patient alcoholics in Scotland. Addiction 1993;88(6):757–66.Google Scholar
Schneider, B. Substance use disorders and risk for completed suicide. Archives of Suicide Research 2009;13(4):303–16.Google Scholar
Dasgupta, N, Beletsky, L, Ciccarone, D. Opioid crisis: no easy fix to its social and economic determinants. American Journal of Public Health 2018;108(2):182–6.Google Scholar
Ellis, MS, Kasper, ZA, Cicero, TJ. Twin epidemics: the surging rise of methamphetamine use in chronic opioid users. Drug Alcohol Dependence 2018;193:1420.Google Scholar
Orpana, HM, Lang, JJ, Baxi, M, et al. Canadian trends in opioid-related mortality and disability from opioid use disorder from 1990 to 2014 through the lens of the Global Burden of Disease Study. Health Promotion and Chronic Disease Prevention in Canada 2018;38(6):234–43.Google Scholar
Brunette, MF, Noordsy, DL, Xie, H, Drake, RE. Benzodiazepine use and abuse among patients with severe mental illness and co-occurring substance use disorders. Psychiatric Services 2003;54(10):1395–401.Google Scholar
Hallahan, B, Murray, I, McDonald, C. Benzodiazepine and hypnotic prescribing in an acute adult psychiatric in-patient unit. Psychiatric Bulletin 2009;33(1):1214.Google Scholar
Drake, R, Mercer-McFadden, C, Mueser, K, McHugo, G, Bond, G. Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophrenia Bulletin 1998;24(4):589608.Google Scholar
Osher, F, Drake, R. Reversing a history of unmet needs: approaches to care for persons with co-occurring addictive and mental disorders. American Journal of Orthopsychiatry 1996;66(1):411.Google Scholar
Renner, JA Jr, Karam-Hage, M, Levinson, M, Craig, T, Eld, B. What do psychiatric residents think of addiction psychiatry as a career? Academic Psychiatry 2009;33(2):139–42.Google Scholar
Tinsley, JA. Workforce information on addiction psychiatry graduates. Academic Psychiatry 2004;28(1):56–9.Google Scholar
Brown, P, Recupero, P, Stout, R. PTSD substance abuse comorbidity and treatment utilization. Addictive Behaviors 1995;20(2):251–4.Google Scholar
Najavits, L, Weiss, R, Shaw, S. The link between substance abuse and posttraumatic stress disorder in women. A research review. American Journal on Addictions 1997; 6(4):273–83.Google Scholar
Kofoed, L, Friedman, M J, Peck, R. Alcoholism and drug abuse in patients with PTSD. Psychiatric Quarterly 1993;64(2):151–71.Google Scholar
Kessler, RC, McGonagle, KA, Zhao, S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archive of General Psychiatry 1994;51(1):819.Google Scholar
Regier, DA, Farmer, ME, Rae, DS, et al. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. Journal of the American Medical Association 1990;264(19):2511–18.Google Scholar
Grilo, C, Martino, S, Walker, M, et al. Controlled study of psychiatric comorbidity in psychiatrically hospitalized young adults with substance use disorders. American Journal of Psychiatry 1997;154(9):1305–7.Google Scholar
Heath, LM, Laporte, L, Paris, J, Hamdullahpur, K, Gill, KJ. Substance misuse is associated with increased psychiatric severity among treatment-seeking individuals with borderline personality disorder. Journal of Personality Disorders 2018;32(5):694708.Google Scholar
Zanarini, MC, Frankenburg, FR, Hennen, J, Reich, DB, Silk, K R. Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. American Journal of Psychiatry 2004;161(11):2108–14.CrossRefGoogle ScholarPubMed
Miller, WR. Motivational interviewing: research, practice, and puzzles. Addictive Behaviors 1996;21(6):835–42.Google Scholar
Rubak, S, Sandbæk, A, Lauritzen, T, Christensen, B. Motivational interviewing: a systematic review and meta-analysis. British Journal of General Practice 2005;55(513):305–12.Google Scholar
DiClemente, C, Nidecker, M, Bellack, A. Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. Journal of Substance Abuse Treatment 2008;34(1):2535.Google Scholar
Oyemade, A. Challenges with false-positive urine drug screens. (Comments & Controversies – letter to editor.) Current Psychiatry 2015;15(3):23–4.Google Scholar
Allen, JP, Litten, RZ. The role of laboratory tests in alcoholism treatment. Journal of Substance Abuse Treatment 2001;20(1):81–5.Google Scholar
Spiegel, D, Dhadwal, N, Gill, F. “I’m sober, doctor, really”: Best biomarkers for underreported alcohol use. Current Psychiatry 2008;7(9):1527.Google Scholar
Akmal, M, Valdin, JR, McCarron, MM, Massry, SG. Rhabdomyolysis with and without acute renal failure in patients with phencyclidine intoxication. American Journal of Nephrology 1981;1(2):91–6.Google Scholar
Baigent, MF. Physical complications of substance abuse: what the psychiatrist needs to know. Current Opinion in Psychiatry 2003;16(3):291–6.Google Scholar
Behan, WM, Bakheit, AM, Behan, PO, More, IA. The muscle findings in the neuroleptic malignant syndrome associated with lysergic acid diethylamide. Journal of Neurology, Neurosurgery & Psychiatry 1991;54(8):741–3.Google Scholar
Devlin, R J, Henry, J A. Clinical review: major consequences of illicit drug consumption. Critical Care 2008;12(1):202. Published online 2008 Jan 8. doi:10.1186/cc6166.Google Scholar
Lieber, CS. Medical disorders of alcoholism. England Journal of Medicine 1995;333(16):1058–65.Google Scholar
Pope, H, Kanayama, G. Bodybuilding’s dark side: clues to anabolic steroid use. Current Psychiatry 2004;3(12):1220.Google Scholar
Weiss, R. Identifying and diagnosing co-occurring disorders. CNS Spectrums 2008; 13(4, Suppl 6):46.Google Scholar
Heilig, M, Egli, M. Pharmacological treatment of alcohol dependence: target symptoms and target mechanisms. Pharmacology and Therapeutics 2006;111(3):855–76.Google Scholar
National Collaborating Centre for Mental Health tRCoP. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. Leicester and London, The British Psychological Society and The Royal College of Psychiatrists 2011.Google Scholar
Khantzian, EJ. The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard Review of Psychiatry 1997;4(5):231–44.Google Scholar
Rodgers, JE, Crouch, MA. Phenobarbital for alcohol withdrawal syndrome. American Journal of Health-System Pharmacy 1999;56(2):175–8.Google Scholar
Sajatovic, M. Treatment for mood and anxiety disorders: quetiapine and aripiprazole. Current Psychiatry Reports 2003;5(4):320–6.Google Scholar
Gao, K, Muzina, D, Gajwani, P, Calabrese, J. Efficacy of typical and atypical antipsychotics for primary and co-morbid anxiety symptoms or disorders: a review. Journal of Clinical Psychiatry 2006;67(9):1327–40.Google Scholar
Hoffman, E, Mathew, S. Anxiety disorders: a comprehensive review of pharmacotherapies. Mount Sinai Journal of Medicine 2008;75(3):248–62.Google Scholar
Addolorato, G, Caputo, F, Capristo, E, et al. Baclofen efficacy in reducing alcohol craving and intake: a preliminary double-blind randomized controlled study. Alcohol and Alcoholism 2002;37(5), 504–8.Google Scholar
Flannery, B, Garbutt, J, Cody, M, et al. Baclofen for alcohol dependence: a preliminary open-label study. Alcoholism, Clinical and Experimental Research 2004;28(10):1517–23.Google Scholar
Strawn, J, Geracioti, T Jr. The treatment of generalized anxiety disorder with pregabalin, an atypical anxiolytic. Neuropsychiatric Disease and Treatment 2007;3(2):237–43.CrossRefGoogle ScholarPubMed
George, S, Day, E. Buprenorphine in the treatment of opioid dependence. British Journal of Hospital Medicine 2007;68(11):594–7.Google Scholar
Malinoff, HL, Barkin, RL, Wilson, G. Sublingual buprenorphine is effective in the treatment of chronic pain syndrome. American Journal of Therapeutics 2005;12(5):379–84.Google Scholar
Gray, S, Fatovich, D, McCoubrie, D, Daly, F. Amphetamine-related presentations to an inner-city tertiary emergency department: a prospective evaluation. Medical Journal of Australia 2007;186(7):336–9.Google Scholar
McGregor, C, Srisurapanont, M, Jittiwutikarn, J, et al. The nature, time course and severity of methamphetamine withdrawal. Addiction 2005;100(9):1320–9.Google Scholar
Brown, E, Nejtek, V, Perantie, D, Bobadilla, L. Quetiapine in bipolar disorder and cocaine dependence. Bipolar Disorders 2002;4(6):406–11.Google Scholar
Elkis, H. Treatment-resistant schizophrenia. Psychiatric Clinics of North America 2007;30(3):511–33.Google Scholar
McCabe, S, Knight, J, Teter, C, Wechsler, H. Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey. Addiction 2005;100(1):96106.Google Scholar
Wilens, TE. Impact of ADHD and its treatment on substance abuse in adults. Journal of Clinical Psychiatry 2004;65(3):3845.Google Scholar
Raphael, B, Wooding, S, Stevens, G, Connor, J. Comorbidity: cannabis and complexity. Journal of Psychiatric Practice 2005;11(3):161–76.Google Scholar
Winklbaur, B, Ebner, N, Sachs, G, Thau, K, Fischer, G. Substance abuse in patients with schizophrenia. Dialogues in Clinical Neuroscience 2006;8(1):3743.Google Scholar
Di Forti, M, Morrison, PD, Butt, A, Murray, RM. Cannabis use and psychiatric and cognitive disorders: the chicken or the egg? Current Opinion in Psychiatry 2007;20(3):228–34.Google Scholar
Compton, MT, Kelley, ME, Ramsay, CE, et al. Association of pre-onset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients. American Journal of Psychiatry 2009;166(11):1251–7.Google Scholar
Freedman, R. Cannabis, inhibitory neurons, and the progressive course of schizophrenia. American Journal of Psychiatry 2008;165(4):416–19.Google Scholar
Pope, HG Jr, Gruber, AJ, Choi, P, Olivardia, R, Phillips, KA. Muscle dysmorphia. An underrecognized form of body dysmorphic disorder. Psychosomatics 1997;38(6):548–57.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×