CHARACTERISTICS AND ASSOCIATED CIRCUMSTANCES

As per the bibliographical review carried out by our technicians, (refer to Literature), and with which we generally agree, we have seen an increase on the prevalence of cases of dual diagnosis.
The crossed association of two disorders brings to light a series of consequences, amongst them:

- higher assistance costs.
- higher clinical severity.
- worse prognosis at short, medium and long term.
- difficulties in an accurate diagnosis
- high degree of contradictions among the professionals with regards to the various therapeutical approaches.
The crossed association of two disorders brings to light a series of consequences, amongst them:

- higher assistance costs.
- higher clinical severity.
- worse prognosis at short, medium and long term.
- difficulties in an accurate diagnosis
- high degree of contradictions among the professionals with regards to the various therapeutical approaches.

Moreover, there are obstacles when trying to identify and detect the potential cases of Dual Diagnosis. These difficulties could be explained as follows:

1) There are dual diagnosis patients in all types and stages of psychiatric therapeutic programs and drug addiction programs, but frequently the “second” diagnosis is not identified.
- In psychiatric units, the concealed abuse of substances tends to lead to:

 

1. An incorrect diagnosis.

2. Confusion among professionals, since the patient does not adequately respond to medication or psychotherapies.

3. An erroneous therapeutical connection.

 - In drug addiction units, the existence of non-identified psychiatric disorders in the        pursuit of abstinence, could lead to blaming the patient for:

 

1. lack of compliance

2. lack of motivation

3. lack of preparation

 

2) One of the main obstacles when detecting other co-existent disorders comes from the attitude and knowledge of each professional and the institution’s policy.

With regards to professionals, we can find:

- A moralist or alarmist attitude or their rejection either because of the substance abuse or because of the existence of a psychiatric disorder, in psychiatric units and drug dependency units respectively.
- Low training on coexistent problems suffered by patients who go to those units.

With regards to the institution, in the literature we can find:

- Policies regarding not accepting or expelling patients who abuse substances in the psychiatric treatment units.
- A mention, explicit or implicit, that the existence of psychiatric disorders could risk the relationship between the patient and the therapeutic program in drug addiction units.

• Definitions
• Characteristics
• Origin of the disorder
• Explicatory Models
• Operational hypothesis
• Complementary Hypothesis

• Context
• Definitions
• Characteristics and associated circumstances
• Origin of the disorder and clinical predominance
• Explicatory Models
• Operational hypothesis: Crossed vulnerability
• Complementary Hypothesis