Advertisement

Dual Disorders: Addiction and Other Mental Disorders. Integrating Mental Health

  • Néstor Szerman
  • Carlos Parro-Torres
  • Javier Didia-Attas
  • Nady El-Guebaly
Chapter

Abstract

Understanding dual disorders (DDs) implies recognizing that an addiction is a mental illness and therefore a brain disease. There are common brain areas involved in both addictions and other mental illnesses; it could explain the high comorbidity between drug use and other psychiatric disorders. Factors increasing the vulnerability to develop an addiction include family history, early initiation of substance use, socially stressful environments and suffering from a mental illness. In addition, lifetime diagnosis of any mental illness has been found to be associated with higher prevalence of transition from substance use to substance use disorder. Social influences are critical factors that promote experimentation or initiation which, combined with an individual vulnerability, may lead to a substance use disorder development. Historically, there has been an artificial separation between services treating addiction disorders and services treating other mental illnesses. The new paradigm of addiction, which indicates that DDs are a brain disease, highlights the need to reconsider this model.

Keywords

Dual disorders Addiction Comorbidity Substance use 

References

  1. 1.
    Volkow ND, Koob GF, McLellan AT. Neurobiologic advances from the brain disease model of addiction. N Engl J Med. 2016;374(4):363–71.CrossRefGoogle Scholar
  2. 2.
    Drake RE, Mueser KT, Brunette MF, McHugo GJ. A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatr Rehabil J. 2004;27(4):360–74.CrossRefPubMedGoogle Scholar
  3. 3.
    Banerjee S, Clancy C, Crome I. Co-existing problems of mental disorder and substance misuse (dual diagnosis). An information manual—2002. London: Royal College of Psychiatrists Research Unit; 2002.Google Scholar
  4. 4.
    Arias F, Szerman N, Vega P, Mesias B, Basurte I, Morant C, et al. Madrid study on the prevalence and characteristics of outpatients with dual pathology in community mental health and substance misuse services. Adicciones. 2013;25(2):118–27.CrossRefPubMedGoogle Scholar
  5. 5.
    Feinstein AR. The pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis. 1970;23(7):455–68.CrossRefPubMedGoogle Scholar
  6. 6.
    Morisano D, Babor TF, Robaina KA. Co-occurrence of substance use disorders with other psychiatric disorders: implications for treatment services. Nordic Stud Alcohol Drugs. 2014;31(1):5–25.CrossRefGoogle Scholar
  7. 7.
    Arias F, Szerman N, Vega P, Mesias B, Basurte I, Rentero D. Bipolar disorder and substance use disorders. Madrid study on the prevalence of dual disorders/pathology. Adicciones. 2016;29(3):186–94.CrossRefGoogle Scholar
  8. 8.
    Budney AJ. Are specific dependence criteria necessary for different substances: how can research on cannabis inform this issue? Addiction. 2006;101(Suppl 1):125–33.CrossRefPubMedGoogle Scholar
  9. 9.
    Muthen B. Should substance use disorders be considered as categorical or dimensional? Addiction. 2006;101(Suppl 1):6–16.CrossRefPubMedGoogle Scholar
  10. 10.
    Groman SM, Jentsch JD. Cognitive control and the dopamine D(2)-like receptor: a dimensional understanding of addiction. Depress Anxiety. 2012;29(4):295–306.CrossRefPubMedGoogle Scholar
  11. 11.
    Baillie AJ, Teesson M. Continuous, categorical and mixture models of DSM-IV alcohol and cannabis use disorders in the Australian community. Addiction. 2010;105(7):1246–53.CrossRefPubMedGoogle Scholar
  12. 12.
    Helzer JE, van den Brink W, Guth SE. Should there be both categorical and dimensional criteria for the substance use disorders in DSM-V? Addiction. 2006;101(Suppl 1):17–22.CrossRefPubMedGoogle Scholar
  13. 13.
    Fraguas D, Diaz-Caneja CM, State MW, O'Donovan MC, Gur RE, Arango C. Mental disorders of known aetiology and precision medicine in psychiatry: a promising but neglected alliance. Psychol Med. 2016;23:1–5.Google Scholar
  14. 14.
    Compton WM, Dawson DA, Goldstein RB, Grant BF. Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol. Drug Alcohol Depend. 2013;132(1–2):387–90.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Grant BF, Goldstein RB, Chou SP, Huang B, Stinson FS, Dawson DA, et al. Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Mol Psychiatry. 2009;14(11):1051–66.CrossRefPubMedGoogle Scholar
  16. 16.
    Pang RD, Farrahi L, Glazier S, Sussman S, Leventhal AM. Depressive symptoms, negative urgency and substance use initiation in adolescents. Drug Alcohol Depend. 2014;144:225–30.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Blanco C, Alderson D, Ogburn E, Grant BF, Nunes EV, Hatzenbuehler ML, et al. Changes in the prevalence of non-medical prescription drug use and drug use disorders in the United States: 1991–1992 and 2001–2002. Drug Alcohol Depend. 2007;90(2):252–60.CrossRefPubMedGoogle Scholar
  18. 18.
    Dawson DA, Goldstein RB, Grant BF. Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up. Alcohol Clin Exp Res. 2007;31(12):2036–45.CrossRefPubMedGoogle Scholar
  19. 19.
    Blanco C, Alegria AA, Liu SM, Secades-Villa R, Sugaya L, Davies C, et al. Differences among major depressive disorder with and without co-occurring substance use disorders and substance-induced depressive disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2012;73(6):865–73.CrossRefPubMedGoogle Scholar
  20. 20.
    Mann K, Fauth-Buhler M, Higuchi S, Potenza MN, Saunders JB. Pathological gambling: a behavioral addiction. World Psychiatry. 2016;15(3):297–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Potenza MN. Should addictive disorders include non-substance-related conditions? Addiction. 2006;101(Suppl 1):142–51.CrossRefPubMedGoogle Scholar
  22. 22.
    Shaffer HJ. Strange bedfellows: a critical view of pathological gambling and addiction. Addiction. 1999;94(10):1445–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Kraus SW, Voon V, Kor A, Potenza MN. Searching for clarity in muddy water: future considerations for classifying compulsive sexual behavior as an addiction. Addiction. 2016;111(12):2113–4.CrossRefPubMedGoogle Scholar
  24. 24.
    Kraus SW, Voon V, Potenza MN. Should compulsive sexual behavior be considered an addiction? Addiction. 2016;111(12):2097–106.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Crockford D, Quickfall J, Currie S, Furtado S, Suchowersky O, El-Guebaly N. Prevalence of problem and pathological gambling in Parkinson's disease. J Gambl Stud. 2008;24(4):411–22.CrossRefPubMedGoogle Scholar
  26. 26.
    el-Guebaly N, Mudry T, Zohar J, Tavares H, Potenza MN. Compulsive features in behavioural addictions: the case of pathological gambling. Addiction. 2012;107(10):1726–34.CrossRefPubMedGoogle Scholar
  27. 27.
    Potenza MN. Commentary on: are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Defining and classifying non-substance or behavioral addictions. J Behav Addict. 2015;4(3):139–41.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Gearhardt AN, Grilo CM, DiLeone RJ, Brownell KD, Potenza MN. Can food be addictive? Public health and policy implications. Addiction. 2011;106(7):1208–12.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Szerman N, Vega P, Grau-Lopez L, Barral C, Basurte-Villamor I, Mesias B, et al. Dual diagnosis resource needs in Spain: a national survey of professionals. J Dual Diagn. 2014;10(2):84–90.CrossRefPubMedGoogle Scholar
  30. 30.
    Volkow N. Comorbidity: addiction and other mental illnesses. Bethesda: National Institute on Drug Abuse; 2009.Google Scholar
  31. 31.
    Drake RE, Green AI. A call for creativity in dual diagnosis research. J Dual Diagn. 2015;11(2):93–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Stanis JJ, Andersen SL. Reducing substance use during adolescence: a translational framework for prevention. Psychopharmacology. 2014;231(8):1437–53.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Simon N, Belzeaux R, Adida M, Azorin JM. Negative symptoms in schizophrenia and substance-related disorders. L'Encéphale. 2015;41(6 Suppl 1):6S27–31.CrossRefPubMedGoogle Scholar
  34. 34.
    Wilens TE, Martelon M, Joshi G, Bateman C, Fried R, Petty C, et al. Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. J Am Acad Child Adolesc Psychiatry. 2011;50(6):543–53.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Lev-Ran S, Imtiaz S, Rehm J, Le Foll B. Exploring the association between lifetime prevalence of mental illness and transition from substance use to substance use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Am J Addict. 2013;22(2):93–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Wilens TE, Adamson J, Monuteaux MC, Faraone SV, Schillinger M, Westerberg D, et al. Effect of prior stimulant treatment for attention-deficit/hyperactivity disorder on subsequent risk for cigarette smoking and alcohol and drug use disorders in adolescents. Arch Pediatr Adolesc Med. 2008;162(10):916–21.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Griffin KW, Botvin GJ. Evidence-based interventions for preventing substance use disorders in adolescents. Child Adolesc Psychiatr Clin N Am. 2010;19(3):505–26.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Drake RE, Essock SM, Shaner A, Carey KB, Minkoff K, Kola L, et al. Implementing dual diagnosis services for clients with severe mental illness. Psychiatr Serv. 2001;52(4):469–76.CrossRefPubMedGoogle Scholar
  39. 39.
    Lipari RN, Hedden SL, Hughes A. Substance use and mental health estimates from the 2013 National Survey on Drug Use and Health: Overview of findings. The CBHSQ Report. Rockville: Substance Abuse and Mental Health Services Administration; 2013.Google Scholar
  40. 40.
    Narrow WE, Regier DA, Rae DS, Manderscheid RW, Locke BZ. Use of services by persons with mental and addictive disorders. Findings from the National Institute of Mental Health Epidemiologic Catchment Area Program. Arch Gen Psychiatry. 1993;50(2):95–107.CrossRefPubMedGoogle Scholar
  41. 41.
    Kessler RC, Avenevoli S, McLaughlin KA, Green JG, Lakoma MD, Petukhova M, et al. Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Psychol Med. 2012;42(9):1997–2010.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Kessler RC, Birnbaum H, Demler O, Falloon IR, Gagnon E, Guyer M, et al. The prevalence and correlates of nonaffective psychosis in the National Comorbidity Survey Replication (NCS-R). Biol Psychiatry. 2005;58(8):668–76.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Miquel L, Roncero C, Lopez-Ortiz C, Casas M. Epidemiological and diagnostic axis I gender differences in dual diagnosis patients. Adicciones. 2011;23(2):165–72.CrossRefPubMedGoogle Scholar
  44. 44.
    Compton WM, Dawson DA, Conway KP, Brodsky M, Grant BF. Transitions in illicit drug use status over 3 years: a prospective analysis of a general population sample. Am J Psychiatry. 2013;170(6):660–70.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Volkow ND, Fowler JS, Wang GJ, Swanson JM, Telang F. Dopamine in drug abuse and addiction: results of imaging studies and treatment implications. Arch Neurol. 2007;64(11):1575–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Mendelsohn CP, Kirby DP, Castle DJ. Smoking and mental illness. An update for psychiatrists. Australas Psychiatry. 2015;23(1):37–43.CrossRefPubMedGoogle Scholar
  47. 47.
    Sheals K, Tombor I, McNeill A, Shahab L. A mixed-method systematic review and meta-analysis of mental health professionals’ attitudes toward smoking and smoking cessation among people with mental illnesses. Addiction. 2016;111(9):1536–53.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Murray RM, Quigley H, Quattrone D, Englund A, Di Forti M. Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry. 2016;15(3):195–204.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, et al. Prevalence of marijuana use disorders in the United States between 2001–2002 and 2012–2013. JAMA Psychiatry. 2015;72(12):1235–42.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Yuodelis-Flores C, Ries RK. Addiction and suicide: a review. Am J Addict. 2015;24(2):98–104.CrossRefPubMedGoogle Scholar
  51. 51.
    Borges G, Loera CR. Alcohol and drug use in suicidal behaviour. Curr Opin Psychiatry. 2010;23(3):195–204.CrossRefPubMedGoogle Scholar
  52. 52.
    Borges G, Walters EE, Kessler RC. Associations of substance use, abuse, and dependence with subsequent suicidal behavior. Am J Epidemiol. 2000;151(8):781–9.CrossRefPubMedGoogle Scholar
  53. 53.
    Conner KR, Pinquart M, Gamble SA. Meta-analysis of depression and substance use among individuals with alcohol use disorders. J Subst Abus Treat. 2009;37(2):127–37.CrossRefGoogle Scholar
  54. 54.
    Conner KR, Gamble SA, Bagge CL, He H, Swogger MT, Watts A, et al. Substance-induced depression and independent depression in proximal risk for suicidal behavior. J Stud Alcohol Drugs. 2014;75(4):567–72.CrossRefPubMedGoogle Scholar
  55. 55.
    Conner KR, Duberstein PR. Predisposing and precipitating factors for suicide among alcoholics: empirical review and conceptual integration. Alcohol Clin Exp Res. 2004;28(5 Suppl):6S–17S.CrossRefPubMedGoogle Scholar
  56. 56.
    Gonzalez VM, Bradizza CM, Collins RL. Drinking to cope as a statistical mediator in the relationship between suicidal ideation and alcohol outcomes among underage college drinkers. Psychol Addict Behav. 2009;23(3):443–51.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Szerman N, Martinez-Raga J, Peris L, Roncero C, Basurte I, Vega P, et al. Rethinking dual disorders/pathology. Addict Disord Their Treat. 2013;12(1):1–10.CrossRefGoogle Scholar
  58. 58.
    Verdejo-Garcia A, Bechara A. A somatic marker theory of addiction. Neuropharmacology. 2009;56(Suppl 1):48–62.CrossRefPubMedGoogle Scholar
  59. 59.
    Garcia-Garcia I, Horstmann A, Jurado MA, Garolera M, Chaudhry SJ, Margulies DS, et al. Reward processing in obesity, substance addiction and non-substance addiction. Obes Rev. 2014;15(11):853–69.CrossRefPubMedGoogle Scholar
  60. 60.
    Wilcox CE, Pommy JM, Adinoff B. Neural circuitry of impaired emotion regulation in substance use disorders. Am J Psychiatry. 2016;173(4):344–61.CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Koob GF, Volkow ND. Neurocircuitry of addiction. Neuropsychopharmacology. 2010;35(1):217–38.CrossRefPubMedGoogle Scholar
  62. 62.
    Schultz W. Getting formal with dopamine and reward. Neuron. 2002;36(2):241–63.CrossRefPubMedGoogle Scholar
  63. 63.
    Hyatt CJ, Assaf M, Muska CE, Rosen RI, Thomas AD, Johnson MR, et al. Reward-related dorsal striatal activity differences between former and current cocaine dependent individuals during an interactive competitive game. PLoS One. 2012;7(5):e34917.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Olsen VV, Lugo RG, Sutterlin S. The somatic marker theory in the context of addiction: contributions to understanding development and maintenance. Psychol Res Behav Manag. 2015;8:187–200.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Arias F, Szerman N, Vega P, Mesias B, Basurte I, Morant C, et al. Abuse or dependence on cannabis and other psychiatric disorders. Madrid study on dual pathology prevalence. Actas Esp Psiquiatr. 2013;41(2):122–9.PubMedGoogle Scholar
  66. 66.
    Wang Y, Zhu J, Li Q, Li W, Wu N, Zheng Y, et al. Altered fronto-striatal and fronto-cerebellar circuits in heroin-dependent individuals: a resting-state FMRI study. PLoS One. 2013;8(3):e58098.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Durrant R, Adamson S, Todd F, Sellman D. Drug use and addiction: evolutionary perspective. Aust N Z J Psychiatry. 2009;43(11):1049–56.CrossRefPubMedGoogle Scholar
  68. 68.
    Volkow ND, Koob G. Brain disease model of addiction: why is it so controversial? Lancet Psychiatry. 2015;2(8):677–9.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Szerman N, Lopez-Castroman J, Arias F, Morant C, Babin F, Mesias B, et al. Dual diagnosis and suicide risk in a Spanish outpatient sample. Subst Use Misuse. 2012;47(4):383–9.CrossRefPubMedGoogle Scholar
  70. 70.
    van der Pol P, Liebregts N, de Graaf R, Ten Have M, Korf DJ, van den Brink W, et al. Mental health differences between frequent cannabis users with and without dependence and the general population. Addiction. 2013;108(8):1459–69.CrossRefPubMedGoogle Scholar
  71. 71.
    Leyton M, Vezina P. Dopamine ups and downs in vulnerability to addictions: a neurodevelopmental model. Trends Pharmacol Sci. 2014;35(6):268–76.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Schlossarek S, Kempkensteffen J, Reimer J, Verthein U. Psychosocial determinants of cannabis dependence: a systematic review of the literature. Eur Addict Res. 2016;22(3):131–44.CrossRefPubMedGoogle Scholar
  73. 73.
    Darke S, Torok M. The association of childhood physical abuse with the onset and extent of drug use among regular injecting drug users. Addiction. 2014;109(4):610–6.CrossRefPubMedGoogle Scholar
  74. 74.
    Maniglio R. The role of child sexual abuse in the etiology of substance-related disorders. J Addict Dis. 2011;30(3):216–28.CrossRefPubMedGoogle Scholar
  75. 75.
    Drake RE, Wallach MA, Alverson HS, Mueser KT. Psychosocial aspects of substance abuse by clients with severe mental illness. J Nerv Ment Dis. 2002;190(2):100–6.CrossRefPubMedGoogle Scholar
  76. 76.
    Tsitsika A, Critselis E, Louizou A, Janikian M, Freskou A, Marangou E, et al. Determinants of internet addiction among adolescents: a case-control study. Sci World J. 2011;11:866–74.CrossRefGoogle Scholar
  77. 77.
    Wang PS, Angermeyer M, Borges G, Bruffaerts R, Tat Chiu W, De Girolamo G, et al. Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2007;6(3):177–85.PubMedPubMedCentralGoogle Scholar
  78. 78.
    Bahorik AL, Newhill CE, Queen CC, Eack SM. Under-reporting of drug use among individuals with schizophrenia: prevalence and predictors. Psychol Med. 2014;44(1):61–9.CrossRefPubMedGoogle Scholar
  79. 79.
    Van Dorn RA, Desmarais SL, Swartz MS, Young MS, Sellers BG. Letter to the editor: critique of Bahorik et al. (2013)—‘Under-reporting of drug use among individuals with schizophrenia: prevalence and predictors’. Psychol Med. 2014;44(3):668–70.CrossRefPubMedGoogle Scholar
  80. 80.
    Desmarais SL, Van Dorn RA, Sellers BG, Young MS, Swartz MS. Accuracy of self-report, biological tests, collateral reports and clinician ratings in identifying substance use disorders among adults with schizophrenia. Psychol Addict Behav. 2013;27(3):774–87.CrossRefPubMedGoogle Scholar
  81. 81.
    Van Dorn RA, Desmarais SL, Scott Young M, Sellers BG, Swartz MS. Assessing illicit drug use among adults with schizophrenia. Psychiatry Res. 2012;200(2–3):228–36.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Dragogna F, Mauri MC, Marotta G, Armao FT, Brambilla P, Altamura AC. Brain metabolism in substance-induced psychosis and schizophrenia: a preliminary PET study. Neuropsychobiology. 2014;70(4):195–202.CrossRefPubMedGoogle Scholar
  83. 83.
    Daigre C, Roncero C, Grau-Lopez L, Martinez-Luna N, Prat G, Valero S, et al. Attention deficit hyperactivity disorder in cocaine-dependent adults: a psychiatric comorbidity analysis. Am J Addict. 2013;22(5):466–73.CrossRefPubMedGoogle Scholar
  84. 84.
    Ozomaro U, Wahlestedt C, Nemeroff CB. Personalized medicine in psychiatry: problems and promises. BMC Med. 2013;11:132.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Muller-Spahn F. Individualized preventive psychiatry: syndrome and vulnerability diagnostics. Eur Arch Psychiatry Clin Neurosci. 2008;258(Suppl 5):92–7.CrossRefPubMedGoogle Scholar
  86. 86.
    Williams LM. Defining biotypes for depression and anxiety based on large-scale circuit dysfunction: a theoretical review of the evidence and future directions for clinical translation. Depress Anxiety. 2016;34(1):9–24.CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Mestre-Pinto JI, Domingo-Salvany A, Martin-Santos R, Torrens M. Dual diagnosis screening interview to identify psychiatric comorbidity in substance users: development and validation of a brief instrument. Eur Addict Res. 2014;20(1):41–8.CrossRefPubMedGoogle Scholar
  88. 88.
    McDonell MG, Comtois KA, Voss WD, Morgan AH, Ries RK. Global appraisal of individual needs short screener (GSS): psychometric properties and performance as a screening measure in adolescents. Am J Drug Alcohol Abuse. 2009;35(3):157–60.CrossRefPubMedGoogle Scholar
  89. 89.
    Martinez-Raga J, Szerman N, Knecht C, de Alvaro R. Attention deficit hyperactivity disorder and dual disorders. Educational needs for an underdiagnosed condition. Int J Adolesc Med Health. 2013;25(3):231–43.CrossRefPubMedGoogle Scholar
  90. 90.
    Roberts BM, Maybery D. Dual diagnosis discourse in Victoria Australia: the responsiveness of mental health services. J Dual Diagn. 2014;10(3):139–44.CrossRefPubMedGoogle Scholar
  91. 91.
    Balhara YP, Lev-Ran S, Martinez-Raga J, Benyamina A, Singh S, Blecha L, et al. State of training, clinical services, and research on dual disorders across France, India, Israel, and Spain. J Dual Diagn. 2016;12(3–4):252–60.CrossRefPubMedGoogle Scholar
  92. 92.
    Kiluk BD, Carroll KM, Duhig A, Falk DE, Kampman K, Lai S, et al. Measures of outcome for stimulant trials: ACTTION recommendations and research agenda. Drug Alcohol Depend. 2016;158:1–7.CrossRefPubMedGoogle Scholar
  93. 93.
    Minkoff K. Treating comorbid psychiatric and substance use disorders. Psychiatr Times. 2013;30(4):44.Google Scholar
  94. 94.
    Hammond CJ. The role of pharmacotherapy in the treatment of adolescent substance use disorders. Child Adolesc Psychiatr Clin N Am. 2016;25(4):685–711.CrossRefPubMedPubMedCentralGoogle Scholar
  95. 95.
    Gates PJ, Sabioni P, Copeland J, Le Foll B, Gowing L. Psychosocial interventions for cannabis use disorder. Cochrane Database Syst Rev. 2016;5(5):CD005336.Google Scholar
  96. 96.
    Chander G, Himelhoch S, Fleishman JA, Hellinger J, Gaist P, Moore RD, et al. HAART receipt and viral suppression among HIV-infected patients with co-occurring mental illness and illicit drug use. AIDS Care. 2009;21(5):655–63.CrossRefPubMedPubMedCentralGoogle Scholar
  97. 97.
    Gallego L, Barreiro P, Lopez-Ibor JJ. Diagnosis and clinical features of major neuropsychiatric disorders in HIV infection. AIDS Rev. 2011;13(3):171–9.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Néstor Szerman
    • 1
  • Carlos Parro-Torres
    • 2
  • Javier Didia-Attas
    • 3
  • Nady El-Guebaly
    • 4
  1. 1.WPA Section on Dual DisordersHospital General Universitario Gregorio MarañonMadridSpain
  2. 2.Retiro Mental Health ServicesHospital General Universitario Gregorio MarañonMadridSpain
  3. 3.WPA Section on Dual DisordersHospital ItalianoBuenos AiresArgentina
  4. 4.Division of Addiction, Department of PsychiatryUniversity of CalgaryCalgaryCanada

Personalised recommendations