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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568076/ http://dx.doi.org/10.1192/j.eurpsy.2022.1197 |
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author | Lopes, J. Freitas, R. |
author_facet | Lopes, J. Freitas, R. |
author_sort | Lopes, J. |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-9568076 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-95680762022-10-17 Dual Diagnosis, Double Trouble Lopes, J. Freitas, R. Eur Psychiatry Abstract 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. Cambridge University Press 2022-09-01 /pmc/articles/PMC9568076/ http://dx.doi.org/10.1192/j.eurpsy.2022.1197 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Lopes, J. Freitas, R. Dual Diagnosis, Double Trouble |
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 | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568076/ http://dx.doi.org/10.1192/j.eurpsy.2022.1197 |
work_keys_str_mv | AT lopesj dualdiagnosisdoubletrouble AT freitasr dualdiagnosisdoubletrouble |