DUAL DIAGNOSIS
Dual diagnosis means the diagnosis of substance dependence and mental illness.
Introduction:
Substances can cause psychiatric disorders or make it worse. Psychiatric diseases
can cause addiction. This is a highly complicated field and many different situations
are possible. The most common disorders are anxiety, depression, hallucinations,
schizophrenia and confusion. Prolonged, severe use of nicotine can lead to schizophrenia, sedatives can cause anxiety disorders and marijuana often causes panic
attacks and psychosis.
Appearance:
Dual diagnosis occurs frequently but is rarely picked up early enough and treated
correctly. Psychiatric diseases are therefore usually partially and inadequately
treated at treatment centers for substance dependence. The situation causes a lot of
inconvenience, discomfort, suffering relapses and bigger expense. There are many
more complications, doctor visits, poorer results and often leads to suicide.
Statistics:
Substance dependence occurs in about 10% of a population. Approximately 40% to
60% of patients in rehabilitation centers for dependence have a dual diagnosis.
Approximately 33% of patients in psychiatric hospitals are also addicted to drugs
(47% schizophrenics, 22% anxiety attack sufferers, 56% bipolar depression, 18%
depressed patients, 20% to 40% ADHD). These statistics prove that psychiatric
patients addicted to drugs are more than the normal and more dependents suffer
from psychiatric illnesses.
Reasons for addiction and mental disorders:
The reasons for dependence are primarily intoxication, pleasure, recreation, peer
pressure, boredom, stress, curiosity, genetic heredity, self-treatment of problems and
stress, to relieve side effects of medication, etc.. The reasons for mental illness may
be a chemical imbalance in the brain, heredity, traumatic events such as rape, molestation, assault, abuse, etc., overprotection, brain damage, drug addiction and
others. In dual diagnosis treatment must deal with the causes of both conditions.
Principles of treatment for dual diagnosis:
Traditionally substance addiction was treated first and then the psychiatric illness,
but often psychiatric illness has not been treated at all. The best is to treat both conditions simultaneously. A thorough evaluation is needed to ensure dual diagnosis is
correctly diagnosed. The correct medication must be used for both diseases. A biopsycho-social approach is the best because different specialists give inputs, eg. psychiatrist, psychologist, social worker, physician, nurse, etc.. A Halfway House can
help to support and stabilize the patient, where group work is done. The family must
also be trained to safeguard the patient and the family must stay involved with treatment for it to be successful. Treatment has to start immediately. Each recovery plan
is unique and should suit the needs of the patient and family. Psychiatry and clinical
psychology are essential professions in the treatment of dual diagnosis.
Signs of dual diagnosis:
 Frequent relapses on substances
 Abnormal and deviant behavior
 Blackouts and memory loss
 Repression and anxiety
-- Suppressed memory and recalling of unpleasant incidents
 Euphoric recall (recalls only pleasant incidents)
 Mental illnesses such as depression, schizophrenia, anxiety, psychopathy
together with substance abuse
Kobus Pienaar
CAD ORGANIZER
Sources:
Hitzeroth, V and Kramer, L: 2010. The end of addiction.
Barnard, A. 1994. Wie is dit wat onnodig seerkry?