Treatment for dual diagnosis

Treatment for dual diagnosis

Dual diagnosis is the temporal coexistence of two or more psychiatric disorders as defined by the International Classification of Diseases, one of which is problematic substance use.

What works?

  • The therapeutic approach to tackle dual diagnosis, whether pharmacological, psychological or both, must take into account both disorders simultaneously and from the first point of contact in order to choose the best option for each individual
  • Integrated treatment combining pharmacological and psychological interventions seems to help in cases of psychosis and substance use disorders as well as anxiety and opioid disorders
  • The antipsychotic Clozapine helps to control both psychotic symptoms and reduce substance use in dual-diagnosis patients with schizophrenia
  • Therapeutic communities in prison may help to reduce re-incarceration rates of drug-using offenders with co-occurring mental illness

What's unclear?

  • It is not clear if pharmacological and psychosocial treatments for depression can also help to reduce substance use
  • Pharmacological treatment of attention deficit hyperactivity disorder helps reduce ADHD symptoms but has no effect on reducing substance use or improving retention in substance use treatment
  • It is not clear if any specific pharmacotherapy is particularly beneficial in the treatment of personality disorders and substance use comorbidity disorders

What doesn't work?

  • So far, we are not aware of interventions which proved to cause harm

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