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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...

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Detalles Bibliográficos
Autores principales: Lopes, J., Freitas, R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
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.
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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
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