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Current evidence on integrated treatment for serious mental disorder and substance misuse

Kavanagh, David J. & Mueser, Kim T. (2007) Current evidence on integrated treatment for serious mental disorder and substance misuse. Journal of Norwegian Psychological Association, 44(5), pp. 618-637.

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Abstract

Substance misuse in people with serious mental disorders is common and has a wideranging negative impact. The multiplicity of problems suggests that this comorbidity is better conceptualized as a type of complex disorder than by ‘dual diagnosis’. Problems with sequential and parallel treatments have led to the development of integrated approaches, with one practitioner or team addressing both the substance use and mental disorder. These treatments are typically characterized by motivation enhancement, minimizing treatment-related stress, emphasizing harm reduction as well as abstinence, and assertive outreach. A review of published randomized trials demonstrates that superior effects to controls are rarely consistent across treatment foci and over time. While motivational interventions assist engagement, more intervention is usually required for integrated treatment programs to improve long-term outcomes more than control conditions. More intensive case management does not consistently improve impact, but extended cognitive-behavioral therapies have promise. Suggestions for maximizing treatment effects and improving research evidence are provided.

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ID Code: 28657
Item Type: Journal Article
Keywords: comorbidity, serious mental illness, schizophrenia, bipolar disorder, substance misuse, co-occurring disorders, dual disorders
ISSN: 0332-6470
Subjects: Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Past > Schools > School of Physical & Chemical Sciences
Copyright Owner: Copyright 2007 Please consult the authors.
Deposited On: 18 Nov 2009 13:41
Last Modified: 11 Aug 2011 02:21

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