Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 12Co-Occurring Substance Use Disordersand Other Psychiatric DisordersALISA B. BUSCHROGER D. WEISSLISA M. NAJAVITSDetermining better ways to identify and treat individuals with co-occurringsubstance use disorders (SUDs) and other psychiatric disorders has becomeincreasingly important from clinical, research, and policy perspectives. Severalobservations have driven this imperative: (1) Co-occurring SUDs with otherpsychiatric disorders are prevalent (Kessler et al., 1996; Regier et al., 1990) andassociated with worse clinical and functional outcomes than either SUDs orother psychiatric disorders alone (Mueller et al., 1994; Ritsher, McKellar,Finney, Otilingam, & Moos, 2002); (2) many people with these co-occurringdisorders do not receive adequate treatment (Substance Abuse and MentalHealth Service Administration, 2002); and (3) compared to psychiatricpatients without co-occurring SUDs, patients with a dual diagnosis tend to usemore costly treatments, such as emergency and hospital care (Dickey & Azeni,1996; Mark, 2003). Together, these observations have led to the developmentof specific new treatments designed or adapted for this population—althoughthis research is at an early stage.Within SUD populations, multiple substance use disorders are common(Kessler et al., 1997; Regier et al., 1990). While these individuals can also beconsidered “dually diagnosed,” this chapter focuses exclusively on patients whohave an SUD plus a (non-SUD) co-occurring Axis I or II psychiatric disorder.271