Dual diagnosis: alcoholism and co-morbid psychiatric disorders. 2003

Henry R Kranzler, and Richard N Rosenthal
Department of Psychiatry and the Alcohol Research Center, University of Connecticut School of Medicine, Farmington, CT 06030-2103, USA. kranzler@psychiatry.uchc.edu

Although alcohol use disorders are commonly associated with co-morbid drug use and psychiatric disorders, such co-morbidity is frequently underdiagnosed and inadequately treated. This paper reviews the epidemiological, diagnostic, and treatment literature on the co-morbidity of alcoholism, with a focus on the most common co-morbid disorders: drug abuse, mood disorders, anxiety disorders, and antisocial personality disorder. The paper goes on to describe a number of promising approaches to the treatment of these common co-morbid disorders in alcoholics. Despite the difficulties inherent in treating dual diagnosis patients, the clinician must recognize that it is possible to derive valid diagnoses and deliver efficacious treatment to such patients.

UI MeSH Term Description Entries
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000437 Alcoholism A primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. (Morse & Flavin for the Joint Commission of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism: in JAMA 1992;268:1012-4) Alcohol Abuse,Alcoholic Intoxication, Chronic,Ethanol Abuse,Alcohol Addiction,Alcohol Dependence,Alcohol Use Disorder,Abuse, Alcohol,Abuse, Ethanol,Addiction, Alcohol,Alcohol Use Disorders,Chronic Alcoholic Intoxication,Dependence, Alcohol,Intoxication, Chronic Alcoholic,Use Disorders, Alcohol
D000987 Antisocial Personality Disorder A personality disorder whose essential feature is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. The individual must be at least age 18 and must have a history of some symptoms of CONDUCT DISORDER before age 15. (From DSM-IV, 1994). Antisocial Behavior,Deviant Behavior,Dyssocial Behavior,Personality Disorder, Antisocial,Psychopathic Personality,Sociopathic Personality,Antisocial Personality,Antisocial Behaviors,Antisocial Personalities,Antisocial Personality Disorders,Behavior, Antisocial,Behavior, Deviant,Behavior, Dyssocial,Behaviors, Antisocial,Behaviors, Deviant,Behaviors, Dyssocial,Deviant Behaviors,Disorder, Antisocial Personality,Disorders, Antisocial Personality,Dyssocial Behaviors,Personalities, Antisocial,Personalities, Psychopathic,Personalities, Sociopathic,Personality Disorders, Antisocial,Personality, Antisocial,Personality, Psychopathic,Personality, Sociopathic,Psychopathic Personalities,Sociopathic Personalities
D015897 Comorbidity The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D017831 Diagnosis, Dual (Psychiatry) The co-existence of a substance abuse disorder with a psychiatric disorder. The diagnostic principle is based on the fact that it has been found often that chemically dependent patients also have psychiatric problems of various degrees of severity. Dual Diagnosis, Psychiatric,Dual Diagnosis,Psychiatric Diagnosis, Dual,Psychiatric Dual Diagnosis,Diagnoses, Dual,Diagnoses, Dual (Psychiatry),Diagnoses, Dual Psychiatric,Diagnoses, Psychiatric Dual,Diagnosis, Dual,Diagnosis, Dual Psychiatric,Diagnosis, Psychiatric Dual,Dual Diagnoses,Dual Diagnoses (Psychiatry),Dual Diagnoses, Psychiatric,Dual Diagnosis (Psychiatry),Dual Psychiatric Diagnoses,Dual Psychiatric Diagnosis,Psychiatric Diagnoses, Dual,Psychiatric Dual Diagnoses
D019964 Mood Disorders Those disorders that have a disturbance in mood as their predominant feature. Affective Disorders,Affective Disorder,Disorder, Affective,Disorder, Mood,Disorders, Affective,Disorders, Mood,Mood Disorder
D019966 Substance-Related Disorders Disorders related to substance use or abuse. Chemical Dependence,Drug Abuse,Drug Addiction,Drug Dependence,Drug Habituation,Drug Use Disorder,Drug Use Disorders,Organic Mental Disorders, Substance-Induced,Substance Abuse,Substance Dependence,Substance Related Disorder,Substance Use,Substance Use Disorder,Substance Use Disorders,Prescription Drug Abuse,Substance Addiction,Abuse, Drug,Abuse, Prescription Drug,Abuse, Substance,Addiction, Drug,Addiction, Substance,Chemical Dependences,Dependence, Chemical,Dependence, Drug,Dependence, Substance,Dependences, Chemical,Disorder, Drug Use,Disorder, Substance Related,Disorder, Substance Use,Disorders, Substance Related,Drug Abuse, Prescription,Habituation, Drug,Organic Mental Disorders, Substance Induced,Related Disorder, Substance,Related Disorders, Substance,Substance Abuses,Substance Uses,Use, Substance

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