Lecture 5 Flashcards
Most common comorbidities with addiction
Personality disorders:
- PTSD
- Schizophrenia
- Externalizing disorders (ADHD, APD)
- Internalizing disorders (Anxiety, Depression)
Somatic comorbidity
Why is it important to study comorbidities?
- highly prevalent among substance users
- associated with increased levels of clinical and social severity
- associated with poor prognosis of both psychiatric and substance use disorder
- associated with fewer changes of recovery
What comes first - addiction or psychopathology?
. psychology - addiction (self-medication)
- addiction - psychopathology (substance induced)
- common factor pathway (genes, risk environment, personality)
- all pathways are equal present
- but only in some disorders
PTSD and Addiction
Very common 42-95% of addictive patients report traumatic experiences in the past
Hypothese:
- Addiction is self medication
- Chemical association
- Dysregulation of brain stress system
- Substance use makes you more vulnerable for traumatic experiences
- Genetic/ environmental vulnerability
Diagnosis of PTSD should be routine in addiction treatment
Treatment:
- psycho-eduction
- CBT (like seeking safety, or dialectical BT)
- Eye movement desensitization and reprocessing (EMDR)
Schizophrenia and Addiction
About half (47%) of patients with schizophrenia have SUD
Cannabis use as risk factor for schizophrenia
- increases risk with 41%
- correlation also relationship
Treatment:
- psycho-eduction
- psychopharmacology
- increase motivation (MI)
- CBT
- stimulate self help
Externalizing disorders and Addiction
ADHD and SUD:
- prevalence of ADHD in addiction patients much higher than in general population (25%)
Common factor explanation:
- multiple factors that influence comorbidity of SUD and externalizing disorders
Treatment:
- psycho-eduction
- pharmacotherapy
- CBT
Internalizing disorders and addiction
About 20-50% SUD patients have 1 or more internalizing disorders
- Depression: 30-50%
- Anxiety: 10-30%
SUD is seen in patients with mood disorders about 10-30%
- causal relationship
Self-medication Hypothesis:
- higher chance of substance abuse because of self medication to lessen symptoms
Negative reinforcement model - allostasis:
- individual differences in neuropsychology of addiction
Treatment:
- dual-diagnosis treatment
- preferable multidisciplinary: pharmacology, psychology, psychoeduction, and social interventions
Identification and integration treatment
Focuses on functional recovery in terms of multidisciplinary proposals including affective links, social, cultural, and cognitive rehabilitation in order to improve overall quality of life
- best prognosis for comorbidity disorders
