Dual Diagnosis

Dual diagnosis a term which originated in the 1980s and increasingly used by doctors to describe individuals who have D a drug or alcohol problem and suffer from severe D mental illness .There may also be a personality disorder, which co-exists with psychiatric illness and/or substance misuse.

The relationship between the two conditions means that:
  • A primary psychiatric illness can may act as the trigger, which leads to substance misuse
  • Taking specific drugs can increase the risk of developing a mental illness
  • Drug taking can make the symptoms of mental illness worse

Before doctors began making a dual diagnosis - patients who experienced the symptoms of a mental health disorder, such as mood swings, anxiety attacks, depression or delusional behaviour were treated separately from those who sought help for drug or alcohol abuse.

When mental illness and a drug /alcohol problem overlapped – patients were often denied treatment for the mental illness until they could show they were no longer dependent on drugs or alcohol.

Substance abuse is all too often driven by an underlying psychiatric disorder can which meant that many individuals who would today be recognised with a dual diagnosis of addiction and a mental disorder never received the help they needed.

Helping and treating sufferers of dual diagnosis - - is challenging because of complex needs linked to health, social, economic and emotional factors or circumstances often aggravated by substance misuse.

Symptoms and Warning Signs

Distinguishing between drug / alcohol misuse and mental illness - can often be difficult as the symptoms can closely resemble each other and frequently exist together.

Substances which can induce psychotic symptoms from misuse are:

Cannabis - characterised by temporary hallucinations and anxious, paranoid behaviour.
Psycho-stimulants - effects similar to schizophrenia.
Hallucinogens - temporary but can persist with sustained use.
Alcohol - caused by withdrawal and hallucinations from heavy use.

In dual diagnosis, a patient's medical history must be examined to determine if non-substance-induced psychotic disorder:
  • Can be traced in the family
  • Began prior to the onset of substance abuse
  • Persists for longer than one month after acute withdrawal or intoxication
  • Have been present during periods of abstinence

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