Dual diagnosis means that a patient has one or more psychological or psychiatric diagnoses as well as one or more drug and/or alcohol diagnoses. Some examples of dual diagnosis patients are: depression + alcoholism; bipolar disorder + cocaine abuse; posttraumatic stress disorder + benzodiazepine dependence; ADHD + amphetamine dependence; and schizophrenia + hallucinogen abuse. It is important to realize that a dual diagnosis patient can have any psychological or psychiatric diagnosis, even something mild like a phobia, and that a dual diagnosis patient can have more than one such psychological or psychiatric diagnosis. It is also important to realize that a dual diagnosis patient can have chemical dependency and/or drug abuse problems with more than one class of drugs. For example, a patient may be addicted to marijuana and cocaine and heroin.
The treatment of dual diagnosis patients is more complicated than it would be if the patient had only one diagnosis and requires a doctor who is a trained specialist in treating dual diagnosis (sometimes also referred to as “co-occurring disorders”). Treatment of dual diagnosis patients requires a specialist who is qualified to treat each individual condition that the patient has, and who is qualified to manage and coorinate the patient's entire treatment. Such management includes completing an expert differential diagnosis using interview and/or psychological testing to determine which psychiatric diagnoses the patient has and which co-occuring substance use (chemical dependency) diagnoses the patient has; determining the proper level of care for delivery of treatment services; assembling a qualified multidisciplinary treatment team to evaluate for the possible presence of co-occurring medical conditions and determinate the need for medications; assessing other complicating factors such as legal problems and extended family, work, and environmental concerns; and then formulating a comprehensive treatment plan including personally-tailored individual psychotherapy and adjunctive family and couples therapy when indicated. For more information on dual diagnosis, please consult the following resources:
NIMH: www.nlm.nih.gov/medlineplus/dualdiagnosis.html
MedlinePlus: http://www.nlm.nih.gov/medlineplus/dualdiagnosis.html
MHA: www.nmha.org/go/information/get-info/co-occurring-disorders/dual-
diagnosis
NAMI: www.nami.org
SAMHSA: www.samhsa.org
