Dual Diagnosis

1. Front Matter

   Pages i-xxiv

   PDF

2. Evaluation and Diagnosis of Dual Diagnosis Patients

   1. Front Matter

      Pages 1-1

      PDF

   2. Introduction and General Concepts of Dual Diagnosis

      • Sheldon Zimberg

      Pages 3-21

   3. Diagnosis and Differential Diagnosis of Psychiatric and Substance Use Disorders

      • Michael B. First, Madeline M. Gladis

      Pages 23-37

   4. Recognizing Dual Diagnosis Patients in Various Clinical Settings

      • Michael Fayne

      Pages 39-53

3. Treatment of Dual Diagnosis Patients

   1. Front Matter

      Pages 55-55

      PDF

   2. Management of Acute Problems in the Dual Diagnosis Patient

      • Joel Solomon

      Pages 57-76

   3. The Long-Term Treatment of the Dually Diagnosed

      • Edward Shollar

      Pages 77-104

   4. The Role of Self-Help Groups in the Treatment of the Dual Diagnosis Patient

      • Phyllis Zaslav

      Pages 105-126

   5. Countertransference and Attitudes in the Context of Clinical Work with Dually Diagnosed Patients

      • Margaret M. O’Neill

      Pages 127-146

   6. Modified Therapeutic Communities for Dual Disorders

      • George De Leon

      Pages 147-170

   7. Inpatient Treatment for the Dually Diagnosed

      • Marc Galanter, Hugo Franco, Anthony Kim, Elizabeth Jamner Metzger, George De Leon

      Pages 171-192

   8. Special Considerations for Dually Diagnosed Schizophrenics and Their Families

      • Denise Hien

      Pages 193-214

   9. Adolescent Dual Diagnosis

      • Michael Fayne, Denise Hien

      Pages 215-235

4. Program Development, Training, and Research in Dual Diagnosis

   1. Front Matter

      Pages 237-237

      PDF

   2. Program Development

      • John Kastan

      Pages 239-251

   3. Developing Dual Diagnosis Treatment Services within Existing Outpatient Psychiatric and Addictive Disorder Programs

      • Sheldon Zimberg, Joel Solomon, Edward Shollar, Margaret M. O’Neill

      Pages 253-270

   4. Dual Diagnosis Training

      • Margaret M. O’Neill

      Pages 271-285

   5. Research Issues in Dual Diagnosis

      • Edward V. Nunes Jr., Deborah A. Deliyannides

      Pages 287-309

5. Back Matter

   Pages 311-322

   PDF

Patients who have both a psychiatric disorder and a substance abuse problem cause most clinicians to throw up their hands in despair. The clinical problems that these "dual diagnosis" patients present are enor­ mously complex. Diagnostically, how is one to tell if disorders of mood and thinking, for instance, are signs of a mental illness or consequences of substance abuse? How is one to obtain important historic information when the patient may be unable or unwilling to provide it and there are no readily available collateral sources of information? In any case, why bother? Treatments for dually diagnosed patients are ineffective; patients won't stay in treatment; recidivism occurs at a very high rate. To make matters even more difficult, traditional health care reim­ bursement mechanisms do not provide for the multimodality clinical programs and special services needed by the patient who is both mentally ill and a substance abuser. So the clinician needs an effective bureaucratic strategy as well as a treatment strategy. For the most part, clinicians have handled the problem by ignoring it.

• development
• diagnosis
• differential diagnosis
• evaluation
• hospital
• management
• patients
• population
• psychiatry
• research
• training
• treatment

• Columbia University College of Physicians and Surgeons, St. Luke’s/Roosevelt Hospital, New York, USA

  Joel Solomon

• Columbia University College of Physicians and Surgeons, New York, USA

  Sheldon Zimberg

• Treatment Resource Team for Dual Diagnosis and MICA Patients, Department of Psychiatry, St. Luke’s/Roosevelt Hospital, New York, USA

  Sheldon Zimberg, Edward Shollar

Policies and ethics