THE DUAL DIAGNOSIS: SCHIZOPHRENIA AND SUBSTANCE ABUSE

The concept of dual diagnosis means the comorbidity of mental disorders and substance abuse. The prevalence of substance use disorders in the mentally ill and, conversely, the prevalence of mental disorders in the substance users significantly exceed population values, indicating a certain mutual conditioning of both types of disorders. An example of a dual diagnosis is the combination of schizophrenia and addictive disorders. Substance abuse in patients with schizophrenia is associated with worsening of its course, which is manifested by more frequent relapses, increased severity of psychosis, more frequent hospitalizations, lower adherence to therapy, the need for higher doses of antipsychotics, increased incidence of extrapyramidal disorders, a tendency to aggression and violence, and exacerbation of suicidal tendencies. Treatment of patients with a dual diagnosis requires special approaches, and the therapy success depends on a number of conditions including inclusiveness, low thresholds of treatment programs, confidentiality, and transparency of the treatment methods used for patients and their relatives.

dual diagnosis, schizophrenia, substance abuse, antipsychotics, antidepressants, selective serotonin reuptake inhibitors, glutamate antagonists, calcium channels modulators