Dual diagnosis: an intriguing and actual nosographic issue too long neglected

Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip, Rosanna Mancinelli, Giovanni Laviola, Simone Macri

Research output: Contribution to journalReview article

Abstract

Background: The term “dual diagnosis” (DD) has been used in clinical practice for years. However, there is confusion about these medical cases, which consist in the presence of both a psychiatric disorder and a substance abuse disorder (in this case, alcohol). There are evidences that in the alcohol use disorder (AUD) population, 50.3% of patients had a psychiatric comorbidity during their lifetime. Nevertheless, to these days there are not any thorough guidelines for the management of these patients. A precise nosography would prevent delay in diagnosis and treatment and all the self-evident negative outcomes of those delays.

Materials and methods: A literature search was performed in PubMed, Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “etiopathogenesis”, “outpatient”, “inpatient”, “unit”, “diagnosis”. Out of 1045 titles, 43 studies were included in this article for their relevance on definition and nosography of DD.

Results: Taking into account the state of art available in the literature, we contributed to clarify the definition of DD in the alcohol addiction field. Clinical data confirm high prevalence of DD, and allow to better describe and understand the complex relationship between alcohol dependence and other psychiatric diseases.

Conclusions: We believe that a clear nosographic framework and a precise diagnostic process are essential for a timely management of every case, using specific guidelines to standardize and improve clinical practice. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which introduces dimensional approach, could be a useful tool to improve diagnostic accuracy.

Original languageEnglish
Pages (from-to)154-159
Number of pages6
JournalRivista di Psichiatria
Volume53
Issue number3
DOIs
Publication statusPublished - Jun 19 2018

Fingerprint

Dual (Psychiatry) Diagnosis
Psychiatry
Alcohols
Guidelines
Alcoholism
Substance-Related Disorders
Comorbidity
Confusion
PubMed
Diagnostic and Statistical Manual of Mental Disorders
Inpatients
Outpatients
Therapeutics
Population

Keywords

  • Alcoholism/diagnosis
  • Comorbidity
  • Diagnosis, Dual (Psychiatry)/classification
  • Diagnostic and Statistical Manual of Mental Disorders
  • Humans
  • International Classification of Diseases
  • Mental Disorders/diagnosis
  • Practice Guidelines as Topic

Cite this

Dual diagnosis : an intriguing and actual nosographic issue too long neglected. / Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip ; Mancinelli, Rosanna; Laviola, Giovanni; Macri, Simone.

In: Rivista di Psichiatria, Vol. 53, No. 3, 19.06.2018, p. 154-159.

Research output: Contribution to journalReview article

Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip ; Mancinelli, Rosanna ; Laviola, Giovanni ; Macri, Simone. / Dual diagnosis : an intriguing and actual nosographic issue too long neglected. In: Rivista di Psichiatria. 2018 ; Vol. 53, No. 3. pp. 154-159.
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abstract = "Background: The term “dual diagnosis” (DD) has been used in clinical practice for years. However, there is confusion about these medical cases, which consist in the presence of both a psychiatric disorder and a substance abuse disorder (in this case, alcohol). There are evidences that in the alcohol use disorder (AUD) population, 50.3{\%} of patients had a psychiatric comorbidity during their lifetime. Nevertheless, to these days there are not any thorough guidelines for the management of these patients. A precise nosography would prevent delay in diagnosis and treatment and all the self-evident negative outcomes of those delays.Materials and methods: A literature search was performed in PubMed, Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “etiopathogenesis”, “outpatient”, “inpatient”, “unit”, “diagnosis”. Out of 1045 titles, 43 studies were included in this article for their relevance on definition and nosography of DD.Results: Taking into account the state of art available in the literature, we contributed to clarify the definition of DD in the alcohol addiction field. Clinical data confirm high prevalence of DD, and allow to better describe and understand the complex relationship between alcohol dependence and other psychiatric diseases.Conclusions: We believe that a clear nosographic framework and a precise diagnostic process are essential for a timely management of every case, using specific guidelines to standardize and improve clinical practice. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which introduces dimensional approach, could be a useful tool to improve diagnostic accuracy.",
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T2 - an intriguing and actual nosographic issue too long neglected

AU - Interdisciplinary Study Group CRARL - SITAC - SIPaD - SITD - SIPDip

AU - Vitali, Mario

AU - Sorbo, Francesca

AU - Mistretta, Martino

AU - Scalese, Bruna

AU - Porrari, Raffaella

AU - Galli, Domenica

AU - Coriale, Giovanna

AU - Rotondo, Claudia

AU - Solombrino, Simona

AU - Attilia, Maria Luisa

AU - Mancinelli, Rosanna

AU - Laviola, Giovanni

AU - Macri, Simone

PY - 2018/6/19

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N2 - Background: The term “dual diagnosis” (DD) has been used in clinical practice for years. However, there is confusion about these medical cases, which consist in the presence of both a psychiatric disorder and a substance abuse disorder (in this case, alcohol). There are evidences that in the alcohol use disorder (AUD) population, 50.3% of patients had a psychiatric comorbidity during their lifetime. Nevertheless, to these days there are not any thorough guidelines for the management of these patients. A precise nosography would prevent delay in diagnosis and treatment and all the self-evident negative outcomes of those delays.Materials and methods: A literature search was performed in PubMed, Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “etiopathogenesis”, “outpatient”, “inpatient”, “unit”, “diagnosis”. Out of 1045 titles, 43 studies were included in this article for their relevance on definition and nosography of DD.Results: Taking into account the state of art available in the literature, we contributed to clarify the definition of DD in the alcohol addiction field. Clinical data confirm high prevalence of DD, and allow to better describe and understand the complex relationship between alcohol dependence and other psychiatric diseases.Conclusions: We believe that a clear nosographic framework and a precise diagnostic process are essential for a timely management of every case, using specific guidelines to standardize and improve clinical practice. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which introduces dimensional approach, could be a useful tool to improve diagnostic accuracy.

AB - Background: The term “dual diagnosis” (DD) has been used in clinical practice for years. However, there is confusion about these medical cases, which consist in the presence of both a psychiatric disorder and a substance abuse disorder (in this case, alcohol). There are evidences that in the alcohol use disorder (AUD) population, 50.3% of patients had a psychiatric comorbidity during their lifetime. Nevertheless, to these days there are not any thorough guidelines for the management of these patients. A precise nosography would prevent delay in diagnosis and treatment and all the self-evident negative outcomes of those delays.Materials and methods: A literature search was performed in PubMed, Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: “guidelines”, “treatment”, “comorbidity”, “substance abuse”, “alcohol”, “dual-diagnosis”, “etiopathogenesis”, “outpatient”, “inpatient”, “unit”, “diagnosis”. Out of 1045 titles, 43 studies were included in this article for their relevance on definition and nosography of DD.Results: Taking into account the state of art available in the literature, we contributed to clarify the definition of DD in the alcohol addiction field. Clinical data confirm high prevalence of DD, and allow to better describe and understand the complex relationship between alcohol dependence and other psychiatric diseases.Conclusions: We believe that a clear nosographic framework and a precise diagnostic process are essential for a timely management of every case, using specific guidelines to standardize and improve clinical practice. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which introduces dimensional approach, could be a useful tool to improve diagnostic accuracy.

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KW - Comorbidity

KW - Diagnosis, Dual (Psychiatry)/classification

KW - Diagnostic and Statistical Manual of Mental Disorders

KW - Humans

KW - International Classification of Diseases

KW - Mental Disorders/diagnosis

KW - Practice Guidelines as Topic

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DO - 10.1708/2925.29418

M3 - Review article

C2 - 29912218

VL - 53

SP - 154

EP - 159

JO - Rivista di Psichiatria

JF - Rivista di Psichiatria

SN - 0035-6484

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ER -