Research

Comorbidity: Addiction and Other Mental Illnesses
Research Report Series NIDA: National Institute on Drug Abuse

In this report released last December, the ever growing issue of comorbidity and it counterpart dual-diagnosis treatment are carefully explored.

Data indicates that persons diagnosed with mood or anxiety disorders were about twice as likely to suffer also from a drug use disorder (abuse or dependence) compared with respondents in general. Conversely, Persons diagnosed with drug disorders were roughly twice as likely to suffer also from mood and anxiety disorders. Gender is also a factor. For example, the overall rates of abuse and dependence for most drugs tend to be higher among males than females. Males are more likely to suffer also from antisocial personality disorder. In contrast, women have higher rates of amphetamine dependence and higher rates of mood and anxiety disorders.

Establishing causality or directionality between mental illness and drug use disorders is difficult. The report cites three main reasons:

• Drugs of abuse can cause abusers to experience one or more symptoms of another mental illness.
   
• Mental illnesses can lead to drug abuse. Drugs may be used as a form of self-medication.
   
• Both are caused by overlapping factors such as underlying brain deficits, genetic vulnerabilities, and/or early exposure to stress or trauma.

From the research a fundamental belief that the conditions should be treated concurrently is emerging. Patients who have both a drug use disorder and another mental illness often exhibit symptoms that are more persistent, severe, and resistant to treatment compared with patients who have either disorder alone. Behavioral treatment (alone or in combination with medications) is viewed as the cornerstone to successful outcomes for many individuals. Most clinicians and researchers agree that broad spectrum diagnosis and concurrent therapy will lead to more positive outcomes for patients with comorbid conditions. Preliminary findings support this notion. Examples of Promising Behavioral Therapies for Patients With Comorbid Conditions include: Multisystemic Therapy (MST), Brief Strategic Family Therapy (BSFT), and Cognitive-Behavioral Therapy (CBT) for adolescents. For adults, Therapeutic Communities (TCs), Assertive Community Treatment (ACT), Dialectical Behavior Therapy (DBT), Exposure Therapy, and Integrated Group Therapy (IGT) are all cited.

For the professional:
Learn more about dual-diagnosis capabilities at Rosecrance, downloadable PDF