Substance abuse disorders: a psychiatric priority
Article Abstract:
Estimates are that one out of seven Americans abuse or are dependent upon alcohol. In addition, 1 out of 20 Americans abuse or are dependent upon other drugs. Related morbidity (sickness) and mortality (death) rates are high among substance abusers, and abuse of and dependence on alcohol and other drugs is costly economically. There is a higher prevalence of substance abuse disorders among psychiatric patients than the general population; likewise, those with substance abuse problems have a higher than normal incidence of psychiatric disorders. Despite these facts, the medical community, and in particular, psychiatry, has only very slowly responded to the need for treatment, research, and teaching related to the problems faced by substance abusers. To properly assess substance abuse disorders, it is important that students and residents be taught about them. There are several commonalities in substance abuse disorders as a group that can be taught. For example, the addictive state is similar, regardless of the drug one is addicted to. The signs of addiction must be mastered by clinicians. Psychosocial and biogenetic factors must be understood and the coexistence of psychiatric disorders in substance abusers, and vice versa, should be carefully explored in all related assessments. Particularly, suicidal disorders are clearly correlated with substance abuse disorders and other, more chronic, conditions (e.g., dementia) may emerge following detoxification. In general, rehabilitation, which begins after detoxification, is a four-component process: a psychoeducational program needs to be implemented; families should be involved; self-help groups must supplement other treatment; and treatment with medication may be warranted in some cases. Substance abuse problems are underrecognized and therefore inadequately treated, largely because medical students and residents have not been properly trained to deal with substance abuse problems. This is a deficiency in medical education that must be corrected. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Axis II comorbidity in substance abusers
Article Abstract:
Previous research has shown that psychiatric diagnoses are more common among alcoholics than nonalcoholics. The only personality disorder addressed by the study was antisocial personality disorder. The personality disorders do not lead to symptom-specific treatment and they are likely to complicate the treatment of a substance abuse disorder. For years alcoholics have been classified according to type in hopes of improving treatment. However, further research has failed to lend support to many of these categories. To assess the complex relationship between substance abuse and personality disorders, the prevalence of personality disorders was determined in a group of middle-class substance abusers. The subjects who had personality disorders were compared to those without them. Diagnoses of substance abuse and personality disorder were made using formal diagnostic guidelines as well as standard assessment tests. Of the 100 substance abusers, 57 had personality disorders as well. These patients differed significantly from the 43 without personality disorders in several ways. They were more likely to use illegal drugs, had different patterns of alcohol abuse, had more significant psychiatric difficulties, were less satisfied with their lives, and were more impulsive, isolated, and depressed. Because of the marked differences between the substance abusers with and without personality disorders, a uniform approach to substance abuse treatment may be inadequate. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders
Article Abstract:
The causes of attention deficit hyperactivity disorder, a developmental disorder, are not yet understood, but it is one of the most common reasons that children are referred to specialists. Treatment can be costly for families who may also suffer great stress. Affected children can have problems in school and may later develop criminal and substance abuse problems. Attention deficit hyperactivity disorder has also been observed to be present along with mood, anxiety, and conduct disorders in a number of studies. The present study involved a literature search to identify work that has assessed the comorbidity of attention deficit hyperactivity disorder with other psychiatric and psychological disorders. Evidence was found to suggest that attention deficit hyperactivity disorder is often found in patients who suffer from conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, learning disabilities, and developmental disorders. It is suggested that one approach is to divide children with attention deficit hyperactivity disorder into subgroups by comorbid disorder. Such subgroups would have unique risk factors, clinical courses, and response to medication (the current treatment of choice.) New preventive and treatment strategies may follow as well. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Pindolol and methylphenidate in children with attention-deficit hyperactivity disorder: clinical efficacy and side effects
- Abstracts: Bupropion treatment of attention-deficit hyperactivity disorder in adults. A controlled trial of desipramine in 18 men with posttraumatic stress disorder
- Abstracts: Bupropion treatment of attention-deficit hyperactivity disorder in adults. part 2 Effects of methylphenidate on early adolescent growth
- Abstracts: Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. part 2 Treatment of Alzheimer's disease with short- and long-term oral THA and lecithin: a double-blind study
- Abstracts: More clinical child psychology advances. An information-processing view of children's memory