Assessment of co-occurring addictive and other mental disorder

Abstract

Summary Points:
* Co-occurring addictive and other mental disorders (AMDs) are common, especially in treatment services, so screening for substance use and mental health symptoms should be routine.-----
* Low levels of substance use or psychological problems can have a substantial impact if a companion disorder is severe or if functioning is poor. Screening should not exclusively focus on severe disorder.-----
* AMDs are often more than dual, involving multiple substances and mental disorders, and complex life problems. Comprehensive management requires a wide-ranging assessment.-----
* Symptoms of disorders often overlap, and a confident diagnosis often requires repeated or retrospective assessments.-----
* AMDs sometimes occur in primary–secondary relationships, but often are mutually interacting, and their relationships may change over time. Treatment planning requires consideration of current and future relationships between problems.-----
* Several screening instruments have demonstrated utility in detecting AMDs. Detection of substance use can sometimes be increased by the use of biomedical assays or collateral reports, but more accurate self-reports can often be obtained in AMD populations, provided that trust is developed.-----
* The range and extent of problems in these populations often appear daunting. A review of strengths is important to maintaining the motivation and confidence of both clients and practitioners.-----