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Substance Dependence and Co-occurring Psychiatric Disorders: Best Practices for Diagnosis and Clinical Treatment

SubstanceDependenceCover by Edward V. Nunes, Jeffrey Selzer, Petros Levounis, & Carrie A. Davies (2010).  Kingston, NJ: Civic Research Institute. 632 pages.

The co-occurring disorders of substance abuse and psychiatric disorder are common and well-known. Less is certain about the training clinicians and others require for working with clients or patients, especially those held in custody or under criminal justice supervision. Several years ago, clinicians participating with the National Institute of Drug Abuse Clinical Trials Network formed a Co-occurring Disorders Special Interest Group "to identify important problems related to comorbidity that were confronting clinicians and treatment programs in the field and that should be addressed with research. One issue that emerged repeatedly during discussions was the need to help clinicians who work in substance abuse treatment settings to learn more about co-occurring psychiatric disorders." This book, then, is the first result of these discussions, an effort to coordinate "treatment efforts standards practice."

Edward V. Nunes, Jeffrey Selzer, Petros Levounis, and Carrie A. Davies, the New York-based editors of this volume, are affiliated with the Columbia University College of Physicians and Surgeons, the Albert Einstein College of Medicine, the Division of Addiction Psychiatry at St. Luke's-Roosevelt Hospital, and the New York State Psychiatric Institute at Columbia Presbyterian Medical Center. For them, the particular aim of this volume is to inform substance abuse treatment providers with generalist perspectives on the treatment of patients with psychiatric disorders. This allows them to recognize psychiatric disorders and to make appropriate referrals for them to see suitable specialized treatment providers.

The 20 chapters in this volume are divided into seven parts: mood disorders; anxiety disorders; disorders of attention and cognitive functioning and chronic mental illness; personality disorders; impulse control disorders and eating disorders; special issues such as smoking medical illnesses, adolescent substance abuse, pain, suicide, and drug interactions; and future directions such as the American Society of Addiction Medicine Patient Placement criteria for choosing treatment services and levels of care and future research on treating co-occurring substance abuse and psychiatric disorders.

The first 12 chapters in this volume focus on the diagnosis and treatment of those psychiatric disorders that most commonly affect substance abuse patients, including depression, bipolar and anxiety disorders, schizophrenia, attention deficit hyperactivity disorder, and various cognition, personality, impulse control, and eating disorders. Each chapter offers case examples, diagnostic criteria, natural history and etiology, issues involved with making a diagnosis for substance-dependent patients, instruments and methods for screening and diagnosis, differential diagnosis and overlapping disorders, and treatment options, which offer "hints on how clinicians might tailor a treatment plan to simultaneously treat the psychiatric disorder and a substance abuse disorder, including suggestions on when to elicit the help of a mental health specialist or consultant."

Subsequent chapters in this volume address issues "important for clinicians to consider in the management of substance-dependent patients with co-occurring psychiatric disorders, including nicotine dependence, common medical problems, adolescents and children, pain, suicide, and drug interactions.

Posted Mon, Jun 20 2011 10:28 AM by Tracey Vessels


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