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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2005 June;46(2):119-32

language: English

Management of patients with severe mental illness and co-occurring substance use disorder

Drake R. E., Brunette M. F., Mueser K. T., Green A. I.


This review addresses the management of patients with co-occurring severe mental illnesses, such as schizophrenia and bipolar disorder, and substance use disorder, defined as abuse or dependence on alcohol or other drugs. Recent controlled research studies indicate that individual and group counseling, contingency management, intensive case management, and residential interventions are effective; promising approaches to family intervention and psychopharmacology are currently being tested. Principles of care include integration of mental health and substance abuse interventions, stage-wise interventions that correspond to the patient's level of motivation, long-term care, comprehensive care, and algorithmic care based on treatment response. Future research is expected to refine existing interventions, clarify a typology of dual diagnosis patients, and improve attempts to match patients to treatments.

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