Comorbidity of Addiction and Mental Health Issues

Individuals with dual diagnosis, or comorbid psychological issues, tend to respond more poorly to treatment than those with a single mental health issue. This is especially true for people with addictions and comorbid mental health problems. Opiate use (OP), alcoholism (ALC), and cocaine addiction (COC) are often treated as primary concerns and any existing mental health issues are treated in a secondary fashion.

In substance abuse inpatient settings, treatments are often aimed at both the addiction and the psychological issue. However, in outpatient settings and community treatment environments, existence of a comorbid condition is often overlooked and therefore not treated, or may be treated ineffectively, which ultimately compromises the substance use treatment outcome.

Cesar Pereiro of the Drug Dependency Unit at A Coruna in Spain wanted to get a clearer picture on the rates of comorbidity, especially with respect to specific addictions. Pereiro recently conducted a study that involved 2,300 participants that had received treatment for addictive issues. He used the data from 64 medical professionals who treated them to assess their conditions and determine what comorbidities they had if any. He then categorized each addiction separately and tried to gauge if there was a higher risk for specific mental health issues relative to addiction type.

Pereiro found that more than half of the participants with addictions also had a psychological condition. The most common problems were related to anxiety and mood in the participants with ALC, COC, and OP addictions. In fact, 22.3% of the ALC individuals had mood issues, a finding which is in line with other studies suggesting a strong prevalence of depression in individuals who have alcohol addiction.

Upon further examination, Pereiro also discovered that borderline personality and psychotic conditions were high among the COC addicted participants. This finding was not unexpected as impulsivity, violence, and emotional dysregulation are common features for psychotic individuals and also for people who use stimulants like cocaine. Therefore, the high rates of psychotic episodes and violent outbursts would be expected when both conditions are present.

This research is the first step in illuminating the high rates of comorbidity and the urgent need for treatments that address this issue for people seeking help with addictions.

Pereiro, C., Pino, C., Flórez, G., Arrojo, M., Becoña, E., et al. (2013). Psychiatric comorbidity in patients from the addictive disorders assistance units of Galicia: The COPSIAD Study. PLoS ONE 8(6): e66451. doi:10.1371/journal.pone.0066451

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  • Libba

    July 17th, 2013 at 1:18 PM

    Why don’t the powers that be when it comes to budgeting see this as the same sort of problem that the rest of us sane people out there do? I mean, this is a real problem that we are facing in so many communities, but when the money isn’t there to provide services for these people then you have to know that the problems are going to only get worse as the years go on.
    Sometimes I think that those of us who care the most for other people are seriously in the minority, because if those powers who control the state and federal purse strings cared as much about the well being of their fellow members of society as we so, then maybe we would have been able to get some sort of handle on these lives. At least to the point of helping them learn to magage their illness without feeling as if they have to turn to some sort of illegal and addictive substance as a way to cope.

  • frannie

    July 18th, 2013 at 4:17 AM

    I am afraid that we have become very much a society that blames. . . blame you for your choices even when you have been shown nothing any better, blame you for your addictions even if you have tried everything that you know to do to stop, blame you for your idiosyncrisies, even when really those little things could be the growth of mental illness. I find that if we would take a little more time out to care for one another we would stop playing that blame game and instead help our fellow man. Is this too much to ask?

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