Dual Diagnoses: Relationship Between Drug Misuse and Mental Health Problems

Dual Diagnosis
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Dual Diagnoses
When faced with a new client who has co-occurring psychiatric and substance-related disorders, it is essential to formulate a diagnosis plan that established the causality of symptoms observed in a client. Alsuhaibani et al. (2021) note that the complexity of the diagnosis process increases significantly when a psychologist must diagnose co-occurring psychiatric and substance-related disorders. To this end, a relationship between drug misuse and mental health problems has been acknowledged with substance use shown to exacerbate psychiatric symptoms in a patient.
Notably, the psychiatrist should focus on four main inter-relationships when diagnosing a patient with co-occurring psychiatric and substance-related disorders. First, psychologists should look out for a primary psychiatric condition that leads to the development of substance use disorder in a patient. In such a case, the primary psychiatric illness in a patient is attributed to the primary psychiatric illness or physical illness (Ludici et al., 2020). Second, psychiatrists should keep watch for substance use disorders that exacerbate the symptoms of mental health issues or physical health problems in the patients. Third, psychologists should consider a substance use disorder that results in the development of psychological symptomatology that is not necessarily indicative of an existing psychological diagnosis or social problems. Finally, one must look out for substance use disorders that cause psychiatric illness or social dysfunction in the patients. Identifying the inter-relationship between substance use and symptomatology is considered essential to minimizing the complexity associated with co-occurring psychiatric and substance-related disorders.
Diagnosing co-occurring psychiatric and substance-related disorders requires a detailed evaluation of the patient. The comprehensive assessment of a patient with co-occurring disorders should a clinical interview, self-report questionnaires, and input from family members, friends, or other healthcare providers to establish the interrelationship between substance use and psychiatric symptomatology. The evaluation should commence with screening and assessment within a multi-discipline context to determine the type of substance used by the client. Screening and assessment should be accomplished with the assistance of a wide range of instruments that can identify substance use and should be implemented in such a way that they investigate the use history of the client while providing a perspective on the mental illness of the client (Sullivan, 2022). While the screening and assessment ought to involve medical investigations through the collection and testing of various medical samples, one should not overlook the importance of investigating the social and relationship functioning of the client. The assessment should be prolonged and one must regularly monitor the patient during the assessment to increase the accuracy.
Notably, the evaluation should be able to rule out substance-induced disorders. As Satre et al. (2011) point out, substance-induced disorders typically resolve within a few weeks after cessation of use. If symptoms persist or began before substance use, this may indicate the presence of an underlying mental health disorder.
The assessment for mental health disorders should be based on the use of standardized diagnostic criteria, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM5 allows a psychiatrist to evaluate the client's symptoms against established criteria systematically in a manner that facilitate accurate identification of potential underlying mental health disorder. In some cases, the diagnosis process may be a collaborative process undertaken by a multidisciplinary team if the manifesting symptoms cannot be attributed to either substance abuse or mental health disorder. In addition, one should consider the influence of cultural factors in the diagnostic process. Ludici et al. (2020) point out that one should consider the accuracy of the assessment tool and how it is influenced by cultural factors.
Overall, an accurate diagnosis of co-occurring psychiatric and substance-related disorders requires a multifaceted approach. Clinicians must gather detailed information about the client's substance use history, evaluate symptoms against standardized diagnostic criteria, assess the temporal relationship between substance use and mental health symptoms, and consider cultural factors.
References
Alsuhaibani, R., Smith, D. C., Lowrie, R., Aljhani, S., & Paudyal, V. (2021). Scope, quality, and inclusivity of international clinical guidelines on mental health and substance abuse in relation to dual diagnosis, social and community outcomes: a systematic review. BMC Psychiatry...