Podcast
Questions and Answers
What are some advantages of a collaborative treatment model in dealing with dual diagnosis clients?
What are some advantages of a collaborative treatment model in dealing with dual diagnosis clients?
Uses existing infrastructure, uses each other's expertise, acknowledges the need for close cooperation
What are some disadvantages of a collaborative treatment model in dealing with dual diagnosis clients?
What are some disadvantages of a collaborative treatment model in dealing with dual diagnosis clients?
Communication issues, differing treatment services goals and priorities
What are some key elements that make evidence-based treatment more effective?
What are some key elements that make evidence-based treatment more effective?
Integrated treatment, focused on maintaining motivation & promoting treatment engagement, assertive case management, extends over several months, based on 'no wrong door' approach
What is the majority of research on in evidence-based treatment for dual diagnosis clients?
What is the majority of research on in evidence-based treatment for dual diagnosis clients?
Ceasing substance use is always possible to assist mental health treatment.
Ceasing substance use is always possible to assist mental health treatment.
What is another term for dual diagnosis?
What is another term for dual diagnosis?
What does heterotypic refer to in dual diagnosis?
What does heterotypic refer to in dual diagnosis?
The term 'subsyndromal' refers to individuals who meet the criteria for a diagnosis.
The term 'subsyndromal' refers to individuals who meet the criteria for a diagnosis.
Alcohol __ with medications.
Alcohol __ with medications.
Match the following symptoms with the correct mental health issue: ['feeling tired all the time', 'loss of interest in things', 'muscle tensions and pains']
Match the following symptoms with the correct mental health issue: ['feeling tired all the time', 'loss of interest in things', 'muscle tensions and pains']
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Study Notes
What is Dual Diagnosis?
- Also known as Co-morbidity or Co-occurrence
- Presence of two or more health problems, including medical, mental health, substance use, and intellectual impairment
- Refers to the co-occurrence of a mental health disorder and a substance use disorder
Types of Dual Diagnosis
- Heterotypic: two different classes of mental disorders (e.g., mental health and substance use disorder)
- Homotypic: two disorders within the same class (e.g., two mental health disorders)
- Concurrent: two or more disorders present at the same time
- Successive: disorders occur at different times in a person's life
Incidence of Dual Diagnosis
- Prevalence estimates range from 30% to 90%
- Higher prevalence in substance abuse treatment settings
- More prevalent among Indigenous Australians and females
- Up to 48% of females with alcohol use disorder also have anxiety, affective, or drug use disorder
How Drugs Can Cause Mental Health Problems
- Depressants can cause depression-like symptoms
- Stimulants can cause anxiety and psychosis
- Opioids can cause depression and anxiety through lifestyle factors
- Cannabis can cause depression-like symptoms, anxiety, and psychosis
How Mental Health Can Cause Substance Abuse
- Self-medication of anxiety symptoms with depressant drugs
- Stimulant drugs used to self-medicate depression
- Pain-relieving drugs used to manage chronic emotional pain or trauma
Intermediary Factors and Shared Risk Factors
- Indirect causal relationship between substance abuse and mental health disorders
- Shared risk factors, including lower socioeconomic status, cognitive impairment, and conduct disorder in childhood
Importance of Causality
- Useful in understanding the relationship between substance abuse and mental health disorders
- Mutual influence between the two disorders
Concerns of Dual Diagnosis
- Greater severity of disorders
- Increased risk of relapse
- Poorer treatment outcomes
- Loss of social support networks and extra challenges
Issues for Treatment Services
- Complex presentations and co-occurring disorders
- Lack of dual expertise and awareness of issues
- Diagnostic issues and misdiagnosis
- Inadequate assessment and screening
- Conflicts in philosophies and attitudes between services
Research Perspectives
- No clear answer on causal relationships
- Causal link demonstrated in both directions
- Regardless of relationship, concurrent treatment and management are necessary
Treatment Models
- Sequential: one disorder is treated before the other
- Parallel: two separate practitioners/treatment teams deal with the two separate problems
- Specialized dual diagnosis service: develops expertise within a small group within the service
- Collaborative: uses existing infrastructure and expertise
- Integrated: develops expertise within a small group within the service
Evidence-Based Treatment
- Limited but increasing evidence base
- Integrated approach focusing on maintaining motivation and promoting treatment engagement
- Assertive case management and extended treatment duration
- Pharmacological management, including SSRIs and CBT
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