Dual Diagnosis Flashcards
What are the two types of dual diagnosis distinctions?
- heterotypic/homotypic: mental health and physical disorder vs 2 mental health disorders
- concurrent/successive: alcohol and depression at the same time vs panic disorder in teens and cannabis use in 20s
Almost half of the female population who have an alcohol use disorder also have?
an anxiety disorder
If you are alcohol dependent you are more likely to also have what disorders?
- affective disorder
- anxiety disorder
If you are cannabis dependent you are more likely to also have what disorder?
anxiety disorder
If you are a tobacco user you are more likely to also have what disorders?
- affective disorder
- anxiety disorder
If you have one disorder you have an increased risk of what?
developing other types of disorders
What other disorders are related to meth dependence?
- major depression
- anxiety disorder
How can alcohol cause depression?
- it is a depressant so it causes a depressant effect
- interferes with medication
- long term effect on relationships, employment, health etc
How can cannabis cause depression?
- depressant
- long term use may cause depression-like symptoms
- hypothesised amotivational syndrome
How can opioids cause depression?
- depressant
- Lifestyle-related factors associated with opioid dependence
How can stimulants cause depression?
- Existing depression may get worse when coming down
- Common in the months following cessation
Use/abuse may worsen the sleep/wake cycle
What are some symptoms of an anxiety disorder?
- feeling worried all the time
- getting tired easily
- unable to concentrate
- feeling irritable
- irregular heartbeats or palpitations
- dizziness
- muscle tensions and pains
How can depressants cause anxiety?
- Agitation, anxiety, and irritability are common features of withdrawal
- Alcohol = Alcohol-related problems can create new worries
- Cannabis = Paranoia a common symptom of intoxication
How can stimulants cause anxiety?
- chronic use - anxiety states and panic
- high doses - obsessive cognitions and compulsive behaviours
What causes and what occurs during hangxiety?
- brain activity involving dopamine is lower during a hangover
- heightened stress during a hangover can make it difficult for someone to cope with additional stress
- trouble regulating emotions
How can cannabis cause psychosis?
- Hypothesised to precipitate psychotic episodes
- causal link
- Pharmacology and potency (THC vs CBD)
- Cannabis use increases rates of hospitalisation, psychotic relapse and psychotic symptoms
How can alcohol cause psychosis?
- Negative symptoms worse and affects treatment
- Non-compliance with medication
- Higher relapse rates
How can stimulants cause psychosis?
- May directly cause psychotic episodes
- Amphetamine psychosis: brief psychotic reaction that may last for several weeks
How could mental health cause problems with depressant use?
- Depressant drugs used as a form of “self-medication” of anxiety symptoms
- ‘Social lubricant’
How could mental health cause problems with stimulant use?
- Stimulant drugs used as self-medication of depression
* ‘Pick me up’
How could mental health cause problems with Pain-relieving drug misuse?
- Pain-relieving drugs to manage chronic emotional pain/trauma
- Opiates and sedatives commonly linked to trauma
- ‘Drowning your sorrows’
Why is dual diagnosis of concern?
- greater severity of disorders: relapse risk increased, more symptoms
- loss of social network: double stigmatization
- poorer self-care: increase in risk behaviour, less compliant with medication
What are some issues with treatment services?
- complex presentations
- diagnoses often unclear
- lack of dual expertise or awareness
- added work vs More effective work perceptions
- lack of flexibility in service provision
What are the positive symptoms of Schizophrenia?
○ Hallucinations
○ Delusional thinking
○ Disorganised speech
What are the negative symptoms of Schizophrenia?
○ Flattened affect
○ Lack of motivation
○ Poverty of speech
In treatment services what are some conflicts in philosophies/perspectives of different services?
- Harm minimisation vs Zero tolerance
* Reluctance to work with DD
What is the relationship between mental health and substance use disorders?
- substance use causes mental health disorders
- mental health disorders can lead to substance use
- Mental health disorders and substance abuse disorders develop together and reinforce each other
What makes dual diagnosis treatment more effective?
- Integrated
- Focused on motivation & treatment engagement
- Assertive case management
- Extends over several months
- Based on “no wrong door” approach
