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Abstract

It has been estimated that approximately 32 per cent of people who suffer from schizophrenia use illicit substances (Menezes et al., 1996) and up to 16 per cent drink alcohol to excess (Duke et al., 1994). Such prevalence, despite being lifetime, is disproportionate to the general adult population of this country, and similarly the effects of substance misuse are also more pervading and immediate among those with psychosis. Such people, who are commonly referred to as having a ‘dual diagnosis’, have been shown to be more difficult for traditional mental health services to engage and deliver programmes of care to (Rorstad and Checinski, 1996; Lehman et al., 1994; Smith and Hucker, 1993).

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References

  • American Psychiatric Association (1994) DSM-I, 4th edn, Washington, DC, APA.

    Google Scholar 

  • Carey, K.B. (1996) ‘Substance Use Reduction in the Context of Outpatient Psychiatric Treatment: A Collaborative, Motivational, Harm Reduction Approach’, Community Mental Health Journal, 32(6), 291–306.

    Article  CAS  PubMed  Google Scholar 

  • Day, J., Wood, G., Dewey, G. and Bentall, R. (1995) ‘A Self Rating Scale for Measuring Neuroleptic Side-Effects. Validation in a Group of Schizophrenic Patients’, British Journal of Psychiatry, 166, 650–53.

    Article  CAS  PubMed  Google Scholar 

  • Department of Health (1994) Report of the Inquiry into the Care and Treatment of Christopher Clunis, London, HMSO.

    Google Scholar 

  • DiClemente, C.C. and Prochaska, J.O. (1985) ‘Processes and Stages of Change: coping and competence in smoking behaviour change’, in S. Shiffman and T.A. Wills (eds), Coping and Substance Abuse, New York, Academic Press.

    Google Scholar 

  • Drake, R.E., Bartels, S.J., Teague, G.B., Noordsy, D.L. and Clark, R.E. (1993) ‘Treatment of Substance Abuse in Severe Mental Illness Patients’, Journal of Nervous and Mental Disease, 181, 606–11.

    Article  CAS  PubMed  Google Scholar 

  • Drake, R.E., Mueser, K.T., Clark, R.E. and Wallach, M.A. (1996) ‘The Course, Treatment and Outcome of Substance Disorder in Persons with Severe Mental Illness’, American Journal of Orthopsychiatry, 66(1), 42–51.

    Article  CAS  PubMed  Google Scholar 

  • Drake, R.E. and Osher, F.C. (1997) ‘Treating Substance abuse in patients with severe mental illness’, in S.W. Hengeller and A.B. Santos (eds), Innovative approaches for difficult to treat populations, Washington, DC, American Psychiatric Press.

    Google Scholar 

  • Duke, P.J., Pantelis, C. and Barnes, T.R.E. (1994) ‘South Westminster Schizophrenia Survey; Alcohol Use and Its Relationship to Symptoms, Tardive Dyskinesia and Illness Onset’, British Journal of Psychiatry, 164, 630–36.

    Article  CAS  PubMed  Google Scholar 

  • Gibbins, J. (1998) ‘Towards Integrated Care for Patients With Dual Diagnosis. The Dorset Healthcare NHS Trust Experience’, The Mental Health Review, December, pp. 20–24.

    Google Scholar 

  • Gournay, K. and Sandford, T. (1996) ‘Double Bind,’ Nursing Times, 92(28), 28–9.

    CAS  PubMed  Google Scholar 

  • Graham, H. (1998) ‘The role of Dysfunctional Beliefs in Individuals who Experience Psychosis and Use Substances: Implications for Cognitive Therapy and Medication Adherence’, Behavioural and Cognitive Psychotherapy, 26, 193–208.

    Google Scholar 

  • Graham, H. and Maslin, J. (1998) ‘Introduction to a New Service: COMPASS Programme’, Dual Diagnosis Network (MICAA) News, 2(Summer), p. 2.

    Google Scholar 

  • Holland, M.A. (1998) ‘Substance use and mental health problems: meeting the challenge’, British Journal of Nursing, 7(15), 896–900.

    Article  CAS  PubMed  Google Scholar 

  • Holland, M.A. (1999) How Substance use affects people with mental illness, Nursing Times, 95(24), 46–8.

    CAS  PubMed  Google Scholar 

  • Holland, M., Baguley, I. and Davres, T. (1999) ‘Hallucinations and Delusions 2: A Dual Diagnosis Case Study’, British Journal of Nursing, 8(16), 1095–102.

    Article  CAS  PubMed  Google Scholar 

  • Jeffrey, A. and Ley, A. (1999) Delphi Opinion on Intervention for Severe Mental Illness and Substance Misuse. Participants Report, Torquay, South Devonshire Healthcare Trust.

    Google Scholar 

  • Kavanagh, D., Young, R., Boyce, L., Clair, A., Sitharthan, T., Clark, D. and Thompson, K. (1998) ‘Substance Treatment in Psychosis (STOP): A new intervention for dual diagnosis’, Journal of Mental Health, 7(2), 135–43.

    Article  Google Scholar 

  • Kraweicka, M., Golberg, D. and Vaughan, M. (1977) ‘A Standardised Psychiatric Assessment Scale for Rating Chronic Schizophrenic Patients’, Acta Psychiatrica Scandinavica, 55, 299–308.

    Article  Google Scholar 

  • Lancashire, S., Haddock, G., Butterworth, T., Tarrier, N. and Baguley, I. (1997) ‘Training Mental health Professionals to use Psychosocial Interventions with People who have Severe Mental Health Problems’, Clinician, 14(6), 32–9.

    Google Scholar 

  • Lehman, A., Myers, C., Dickson, L. and Johnson, J. (1994) ‘Defining sub-groups of dual diagnosis patients for service planning’, Hospital and Community Psychiatry, 45, 556–61.

    CAS  PubMed  Google Scholar 

  • Ley, A., Jeffrey, D.P., McLaren, S. and Siegfried, N. (1999) ‘Treatment programmes for people with both severe mental illness and substance misuse’ in The Cochrane Library, Issue 2, Oxford, Update Software.

    Google Scholar 

  • Menezes, P.R., Johnson, S., Thornicroft, G., Marshall, J., Prosser, D., Bebbington, P. and Kuipers, E. (1996) ‘Drug and Alcohol Problems among Individuals with Severe Mental Illnesses in South London’, British Journal of Psychiatry, 168, 612–19.

    Article  CAS  PubMed  Google Scholar 

  • Mitchell, G., Robertson, S. and Weber, G. (1992) ‘A Care Management Project for young adults with dual diagnoses of severe mental illness and substance abuse. A service for people with dual diagnoses’, Journal of Mental Health, 1, 363–6.

    Article  Google Scholar 

  • Mueser, K., Drake, R., Clark, R., McHugo, G., Mercer-McFadden, C. and Ackerson, T. (1995) Toolkit for Evaluating Substance Abuse in Persons with Severe Mental Illness, Concord, NH, Human Services Research Institute.

    Google Scholar 

  • Mueser, K., Drake, R. and Noordsy, D. (1998a) ‘Intergrated Mental Health and Substance Abuse Treatment for Severe Psychiatric Disorders’, Journal of Practical Psychiatry and Behavioural Health, May, pp. 129–39.

    Google Scholar 

  • Mueser, K., Drake, R. and Wallach, M. (1998b) ‘Dual Diagnosis: A review of aetiological theories’, Addictive Behaviours, 23(6), 717–34.

    Article  CAS  Google Scholar 

  • Osher, F.C., Kofoed, L.L. (1989) ‘Treatment of patients with psychiatric and psychoactive substance abuse disorders’, Hospital and Community Psychiatry, 40, 1025–30.

    CAS  PubMed  Google Scholar 

  • Regier, D., Farmer, N. and Rae, D. (1990) ‘Co-morbidity of mental disorders with alcohol and other drugs of abuse: results from the epidemiological catchment area. (ECA)’, Journal of American Medical Association, 264, 2511–18.

    Article  CAS  Google Scholar 

  • Rollnick, S. (1995) ‘What is Motivational Interviewing?’, Behavioural and Cognitive Psychotherapy, 23, 325–34.

    Article  Google Scholar 

  • Rorstad, P. and Checinski, K. (1996) Dual Diagnosis: Facing the Challenge, Kenley, Wynne Howard.

    Google Scholar 

  • Smith, J. and Hucker, S. (1993) ‘Dual Diagnosis Patients; Substance Abuse by the Severely Mentally Ill’, British Journal of Hospital Medicine, 50(11), 650–54.

    CAS  PubMed  Google Scholar 

  • Thomas, M., Brazier, C. and Ferguson, G. (1999) ‘The CASA Multiple Needs Service: Perspectives on Multiple Needs’, National Dual Diagnosis (MICAA) Network News, 4, (Winter 1999), 4–13.

    Google Scholar 

  • World Health Organization (1992) The ICD-IO Clarification of Mental and Behavioural Disorders: Clinical Depression and Diagnostic Guidelines, Geneva, WHO.

    Google Scholar 

  • Zubin, J., and Spring, B. (1977) ‘Vulnerability: a new view of schizophrenia’, Journal of Abnormal Psychology, 86, 103–26.

    Article  CAS  PubMed  Google Scholar 

Download references

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© 2002 Neil Harris, Steve Williams, Tim Bradshaw

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Holland, M. (2002). Dual Diagnosis — Substance Misuse and Schizophrenia. In: Harris, N., Williams, S., Bradshaw, T. (eds) Psychosocial Interventions for People with Schizophrenia. Palgrave, London. https://doi.org/10.1007/978-1-4039-3759-9_14

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