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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