Managing the Dually Diagnosed Patient

David F O'Connell, Eileen P Beyer

• * About the Editors* Contributors* Foreword* Preface to the Second Edition* Section I: Theoretical and Programmatic Issues* Chapter 1. Managing Psychiatric Comorbidity in Inpatient Addictions Treatment* Clinical Management Policy and Procedure Guidelines* Assessment* Clinical Management and Treatment of Coexisting Psychiatric Disorders in Inpatient Addictions Treatment* Appendix: Clinical Protocols for the Treatment of Selected Psychiatric Disorders* Chapter 2. Improving Treatment Adherence Among Patients with Comorbid Psychiatric and Substance Use Disorders* Introduction and Overview* The Problem of Poor Treatment Adherence* Determinants of Treatment Adherence* Effects of Poor Adherence* Strategies That Improve Adherence* Systems Strategies to Improve Adherence* Conclusions and Recommendations* Suggested Patient Educational Videos* Chapter 3. Psychopathology and Substance Abuse: A Psychoanalytic Perspective* Libido and Personality Development* Early versus Later Psychoanalytic Thought* The Borderline Personality* A Few Nonanalytic Ideas* Comments* Implications of the Theory for the Nonanalytic Clinician* Glossary* Section II: Treatment Considerations with Special Populations* Chapter 4. Females with Dual Diagnoses: Implications for Specialized Clinical Approaches* Introduction* Gender Differences in Addiction* Context of Comorbidity: Relational Perspective* Gender Differences and Similarities in Psychiatric Comorbidity* Major Psychiatric Comorbidities in Addicted Women: Depression, Dissociative Disorders, and Eating Disorders* Need for Specialized Women’s Treatment* Summary of Implications for Specialized Treatment Approaches* Chapter 5. Assessing and Treating Psychiatric Comorbidity in Chemically Dependent Adolescents* Literature Review* Assessment* Treatment* Conduct Disorder* Attention Deficit Hyperactivity Disorder* Mood Disorders* Anxiety Disorders* Conclusions* Appendix: Selected Treatment Protocols for Comorbid Disorders* Section III: Assessment and Treatment of Major Mental Disorders* Chapter 6. A Guide to the Assessment of Psychiatric Symptoms in the Addictions Treatment Setting* Introduction: Current Symptoms and Behaviors As a Guide to Addictions Treatment Planning* A Decision Tree for Assessing Psychiatric Symptoms in the Chemically Dependent Individual* Other Factors to Consider in Assessing the Mentally Ill Substance Abuser* Conclusion* Chapter 7. Affective Disorders and Affective Symptoms in Alcoholism* Alcoholism: More Often the Cause or the Result of Depression?* Incidence of Major Depression in Alcoholics* Prevalence of Major Depression in Alcoholics* Economics* Types of Depression* Diagnosis of Affective Disorder in Alcoholism* The Relationship Between Alcoholism and Affective Disorders* Familial Transmission of Alcoholism and Affective Disorders* Genetic Relationship Between Alcoholism and Affective Disorders* Cerebrospinal Fluid* Dexamethasone Suppression Test* Suicide in Depressed Alcoholics* Remission of Alcoholism and Affective Symptoms* Persistence of Affective Disorders in Alcoholism* Drinking Outcome in Affective Disorder* Pharmacological Treatment of Alcohol Dependence* Treatment Strategies for Affective Disorder in Alcoholism* Conclusion: Summary and Treatment Protocols* Chapter 8. Chemical Addictions and Anxiety Disorders: When Adaptive Mechanisms Go Awry* Introduction* The Disease of Addiction* Anxiety and Anxiety Disorders* Comorbidity* The Interaction* Diagnostic Considerations* Conclusion* Chapter 9. Schizophrenia and Substance Abuse* Introduction* Prevalence of Combined Schizophrenia and Substance Abuse* Schizophrenia* The Effect of Schizophrenia in the Subst