Dual Diagnosis

Psychiatric practice requires psychiatrists to, sometimes, treat patients who meet the diagnostic criteria for both a mental disorder (such as psychosis, depression, or anxiety) and addiction (to drugs and alcohol, gambling, gaming, and bitcoin). Lately, the unitary concept of dual diagnosis (or dual disorder) is receiving more and more attention in the field of psychiatry. Patients diagnosed as suffering from both mental health and addiction will be treated holistically by an integrated multidisciplinary team, with therapeutic objectives that monitor the dualistic recovery path of the patient.

Are dual disorders common?

Substance abuse and addictive behaviour occur more frequently in patients with mental health diagnosis which can aggravate this condition and prevent recovery. According to the Public Health England (PHE) guide, 70% of people with mental health disorders also have substance abuse issues.

About dual diagnosis

Dual disorder, which describes the association between a diagnosis of mental disorder (usually severe, psychotic, or affective disorder, ADHD) and behavioural or substance addiction. Neuroscience research has highlighted the anatomical, neural, neurophysiological links between the two sets of symptoms. Addiction is no longer considered a predominantly social disorder, but one that has an important biological component.

The two components of dual diagnosis are closely linked and can influence each other:

  • substance use can cause symptoms of a mental health problem and mimic different mental disorders
  • substance abuse can initiate the development of a mental disorder, cause its recurrence, or aggravate its manifestations
  • substance use may hide some psychiatric symptoms/disorders – in some cases, alcohol or other psychoactive substances are used to reduce some unwanted psychiatric symptoms or to relieve the side effects of medications
  • stopping substance use (withdrawal syndrome) can mimic other psychiatric disorders and lead to an inappropriate diagnosis if the addictive component is not taken into account
  • behaviours caused by a mental disorder can mimic reactions associated with substance use and require an accurate assessment to establish a proper diagnosis

When treating dual diagnosis, Guide to Rehab professionals consider all the patient’s health problems. The online platform is the easiest way to get in touch with specialists that can help with addiction and co-occurring disorders. Rehab centres across the UK can help with overcoming dual disorders.

Diseases associated with alcohol or drug addiction

  • Post-traumatic stress disorder
  • Gambling addiction
  • Depression
  • Anxiety or panic attacks
  • Work stress/exhaustion
  • Mental health problems related to suffering and death
  • Eating Disorders
  • Obsessive-compulsive disorder
  • Compulsive sexual behaviour
  • Cranial trauma
  • Other psychological disorders

Signs & symptoms of dual diagnosis:

Warning signs of a dual diagnosis differ greatly from patient to patient, depending on the type of substance abuse and the co-occurring mental illness:

  • the general behaviour changes suddenly
  • daily tasks and responsibilities are difficult to manage
  • events or social activities are avoided
  • health and hygiene are neglected
  • cognitive impairment or disillusioned thinking
  • do not seek or follow the treatment
  • suicidal thoughts
  • impulsivity and irascibility
  • poor performance at school or work

Several overlapping factors can aggravate the mental health problems of a person with a dual disorder diagnosis:

  • brain responses – drug abuse, such as marijuana, can cause psychosis in some individuals; this is a severe mental disorder that makes people lose touch with reality
  • persistent anxiety, a traumatic event or chronic stress can cause dependence or mental disorder
  • genetics may predispose someone to develop an addiction or a mental disorder
  • those who experience drugs or alcohol at an early age may later develop substance abuse problems and/or mental health disorders

Integrated dual diagnosis treatment

The main elements of the integrated treatment of dual disorders are:

  • coordinated treatment for multiple, coexisting disorders
  • intervention package
  • there is no separation of general psychiatric treatment from addiction treatment
  • all team members – therapists – collaborate to develop a detox recovery treatment for each patient

This approach offers the best chance of success even to the most fragile patients because for patients with a dual diagnosis, treatment can be complex and difficult, as they often present a high risk of relapse. In some cases, care can be fragmented and supervision insufficient. At Guide to Rehab, the parties involved use an integrated approach that requires communication and collaboration efforts in order to administer consistent treatment. The treatment centres listed on Guide to Rehab feature healthcare professionals who pay time and attention to complex cases that need long-term recovery.