Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Introduction
- Part II Summary of treatment modalities in psychiatric disorders
- Part III Specific treatments
- 9 Delirium
- 10 Management of behavioural and psychological symptoms of dementia and acquired brain injury
- 11 Dementia: pharmacological and non-pharmacological treatments and guideline review
- 12 Pharmacological treatment of psychosis and depression in neurological disease in older adults
- 13 Psychological treatments of alcohol use disorders
- 14 Pharmacotherapy of alcohol misuse, dependence and withdrawal
- 15 Educational interventions for alcohol use disorders
- 16 Complex interventions for alcohol use disorders
- 17 Complementary and alternative medicine for alcohol misuse
- 18 Empirically validated psychological therapies for drug dependence
- 19 Treatment of stimulant dependence
- 20 Treatment of opioid dependence
- 21 Treatment of sedative-hypnotic dependence
- 22 Treatment of cannabis dependence
- 23 Treatment of nicotine dependence
- 24 Treatment of co-occurring psychiatric and substance use disorders
- 25 Pharmacological treatments for schizophrenia
- 26 Psychosocial and pharmacological treatments for schizophrenia
- 27 Psychopharmacology of mood disorders
- 28 Efficacy of brain stimulation and neurosurgical procedures for treatment of mood disorders
- 29 Psychotherapy for depression: current empirical status and future directions
- 30 Alternative therapies for mood disorders
- 31 Treatment of generalised anxiety and somatoform disorders
- 32 Panic disorder
- 33 Specific phobias and agoraphobia
- 34 Social phobia
- 35 Obsessive-compulsive disorder
- 36 Post-traumatic stress disorders and adjustment disorders
- 37 Psychopharmacology of eating disorders
- 38 Other somatic physical treatments and complex interventions for eating disorders
- 39 Psychological treatments for eating disorders
- 40 Educational interventions for eating disorders
- 41 Alternative treatments for eating disorders
- 42 Complex treatments for eating disorders
- 43 Personality disorder
- 44 Other treatments for persistent disturbances of behaviour
- 45 Effectiveness of treatments of sexual disorders
- 46 Disorders of gender identity
- 47 Psychological treatments for children and adolescents
- 48 Drugs and other physical treatments
- 49 Educational interventions and alternative treatments
- 50 Attachment insecurity and attachment disorder
- 51 Feeding and sleeping disorders in infancy and early childhood
- 52 Evaluating interventions for children with autism and intellectual disabilities
- 53 ADHD and hyperkinetic disorder
- 54 Oppositional defiant disorder and conduct disorder
- 55 Treatment of depressive disorders in children and adolescents
- 56 Treatment of psychoses in children and adolescents
- 57 Anxiety disorders
- 58 Treatment of eating disorders in children and adolescents
- Appendix I Summary of specific drugs having evidence of effectiveness in mental disorders
- Appendix II Key to effectiveness tables
- Index
- References
24 - Treatment of co-occurring psychiatric and substance use disorders
from Part III - Specific treatments
Published online by Cambridge University Press: 12 May 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Introduction
- Part II Summary of treatment modalities in psychiatric disorders
- Part III Specific treatments
- 9 Delirium
- 10 Management of behavioural and psychological symptoms of dementia and acquired brain injury
- 11 Dementia: pharmacological and non-pharmacological treatments and guideline review
- 12 Pharmacological treatment of psychosis and depression in neurological disease in older adults
- 13 Psychological treatments of alcohol use disorders
- 14 Pharmacotherapy of alcohol misuse, dependence and withdrawal
- 15 Educational interventions for alcohol use disorders
- 16 Complex interventions for alcohol use disorders
- 17 Complementary and alternative medicine for alcohol misuse
- 18 Empirically validated psychological therapies for drug dependence
- 19 Treatment of stimulant dependence
- 20 Treatment of opioid dependence
- 21 Treatment of sedative-hypnotic dependence
- 22 Treatment of cannabis dependence
- 23 Treatment of nicotine dependence
- 24 Treatment of co-occurring psychiatric and substance use disorders
- 25 Pharmacological treatments for schizophrenia
- 26 Psychosocial and pharmacological treatments for schizophrenia
- 27 Psychopharmacology of mood disorders
- 28 Efficacy of brain stimulation and neurosurgical procedures for treatment of mood disorders
- 29 Psychotherapy for depression: current empirical status and future directions
- 30 Alternative therapies for mood disorders
- 31 Treatment of generalised anxiety and somatoform disorders
- 32 Panic disorder
- 33 Specific phobias and agoraphobia
- 34 Social phobia
- 35 Obsessive-compulsive disorder
- 36 Post-traumatic stress disorders and adjustment disorders
- 37 Psychopharmacology of eating disorders
- 38 Other somatic physical treatments and complex interventions for eating disorders
- 39 Psychological treatments for eating disorders
- 40 Educational interventions for eating disorders
- 41 Alternative treatments for eating disorders
- 42 Complex treatments for eating disorders
- 43 Personality disorder
- 44 Other treatments for persistent disturbances of behaviour
- 45 Effectiveness of treatments of sexual disorders
- 46 Disorders of gender identity
- 47 Psychological treatments for children and adolescents
- 48 Drugs and other physical treatments
- 49 Educational interventions and alternative treatments
- 50 Attachment insecurity and attachment disorder
- 51 Feeding and sleeping disorders in infancy and early childhood
- 52 Evaluating interventions for children with autism and intellectual disabilities
- 53 ADHD and hyperkinetic disorder
- 54 Oppositional defiant disorder and conduct disorder
- 55 Treatment of depressive disorders in children and adolescents
- 56 Treatment of psychoses in children and adolescents
- 57 Anxiety disorders
- 58 Treatment of eating disorders in children and adolescents
- Appendix I Summary of specific drugs having evidence of effectiveness in mental disorders
- Appendix II Key to effectiveness tables
- Index
- References
Summary
Editor's note
The co-morbidity of a concurrent substance use disorder and a non-substance major psychiatric disorder is quite common. Yet there is very little data available to inform the clinician as to what treatment(s) might be best for this particular group of patients with this particular set of substance abuse plus non-substance psychiatric co-morbidity. In general, the limited research available, consensus recommendations and clinical experiences all suggest that integrated treatment, i.e. treatment by the same group of providers that addresses both the substance misuse and the other major mental illness is most effective. However, there are exceptions to this rule and providers must be flexible and offer a combination of services regarding what works best in treating the mental disorder plus what works best in the treatment of the specific substance abuse disorder. While on the surface this appears to be logical and pragmatic, this kind of reasoning does not always work. For example, there is some evidence that lithium is less effective in people with bipolar disorder complicated by substance abuse than it is in bipolar disorder alone. Furthermore, some pharmacological agents used to treat some psychiatric disorders have an increased liability for abuse and dependency, suggesting greater caution in using these interventions when substance abuse is a comorbid issue. The most efficacious treatment approach is probably integrated multi-modal treatment which involves the same group of caregivers providing treatment to both the mental illness and the substance misuse disorder.
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- Chapter
- Information
- Cambridge Textbook of Effective Treatments in Psychiatry , pp. 442 - 458Publisher: Cambridge University PressPrint publication year: 2008