Generic placeholder image

Current Drug Research Reviews


ISSN (Print): 2589-9775
ISSN (Online): 2589-9783

Review Article

Even More Complex…. When Mental Disorder Meets Addiction in Youth: Dual Pathology

Author(s): Julio Torales*, João M. Castaldelli-Maia, Antonio Geraldo da Silva, Marcela W. Campos, Israel González-Urbieta and Iván Barrios

Volume 11, Issue 1, 2019

Page: [40 - 43] Pages: 4

DOI: 10.2174/2589977511666181128165358


Background: The management of mental disorders in child and adolescent is challenging. In addition, when substance use disorders are associated with mental disorders, important complications are noted. Dual pathology and Substance-induced disorders should be distinguished in cases like this.

Objective: To summarize the latest information on the epidemiology, etiology and management aspects of dual pathology in adolescents.

Methods: PubMed, Web of Science, PsycINFO and SciELO databases were searched to perform a narrative review.

Results: Dual pathology is the term used to designate the co-occurrence of an addictive disorder and at least one other mental health disorder, independently. To distinguish dual pathology from substance- induced disorders, the temporal association between the disorders in a longitudinal assessment should be emphasized. If the symptoms of the mental disorder appear prior to the substance use or after a long period of abstinence, a diagnosis of dual pathology should be considered. Patients with dual pathology present greater psychosocial issues, more medical problems, and worse prognosis than those with substance-induced disorders. The proposed etiological models agree that biological, psychological and social factors are shared in the development of these conditions.

Conclusion: Healthcare systems should focus on creating policies that will allow early detection, preventive public health measures, and an integrated and coordinated care for these patients. Public health policies should create means to promote awareness and prevention of these pathologies since early initiation of treatment (pharmacological, psychotherapeutic, family therapy, education in schools, behavioral interventions and treatment of comorbidities) reduces the risks associated to substance use disorders and other negative consequences.

Keywords: Substance-related disorders, adolescent psychiatry, comorbidity, pathologies, behavioral interventions, risks.

Graphical Abstract
WPA Section on Dual Disorders. WPA Section on Dual Disorders / Pathology Flyer 10 basic points on dual Pathology : Addiction and other. Ment Illn 2014.
American Psychiatric Association DSM-5. Diagnostic and statistical manual of mental disorders, 2013, pp. 4-5 .
Hasin DS, Trautman KD, Miele GM, Samet S, Smith M, Endicott J. Psychiatric Research Interview for Substance and Mental Disorders (PRISM): Reliability for substance abusers. Am J Psychiatry 1996; 153(9): 1195-201.
Torrens M, Gilchrist G, Domingo-Salvany A. Psychiatric comorbidity in illicit drug users: Substance-induced versus independent disorders. Drug Alcohol Depend 2011; 113(2-3): 147-56.
Rosenberg SD, Goodman LA, Osher FC, et al. Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness. Am J Public Health 2001; 91(1): 31-7.
Martin-Santos R, Fonseca F, Domingo-Salvany A, et al. Dual diagnosis in the psychiatric emergency room in spain. Eur Psychiatry 2006; 20: 147-56.
Hasin D, Liu X, Nunes E, McCloud S, Samet S, Endicott J. Effects of major depression on remission and relapse of substance dependence. Arch Gen Psychiatry 2002; 59(4): 375-80.
Banta LM, Crespi EJ, Nehm RH, et al. Integrating genomics research throughout the undergraduate curriculum: A collection of inquiry-based genomics lab modules. CBE Life Sci Educ 2012; 11(3): 203-8.
Armstrong TD, Costello EJ. Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity. J Consult Clin Psychol 2002; 70(6): 1224-39.
Grilo CM, Becker DF, Fehon DC, Edell WS, McGlashan TH. Conduct disorder, substance use disorders, and coexisting conduct and substance use disorders in adolescent inpatients. Am J Psychiatry 1996; 153(7): 914-20.
Couwenbergh C, van den Brink W, Zwart K, Vreugdenhil C, van Wijngaarden-Cremers P, van der Gaag RJ. Comorbid psycho- pathology in adolescents and young adults treated for substance use disorders. Eur Child Adolesc Psychiatry 2006; 15(6): 319-28.
Drapalski A, Bennett M, Bellack A. Gender differences in substance use, consequences, motivation to change, and treatment seeking in people with serious mental illness. Subst Use Misuse 2011; 46(6): 808-18.
Bender K, Springer DW, Kim JS. Treatment effectiveness with dually diagnosed adolescents: A systematic review. Brief Treat Crisis Interv 2006; 6(3): 177-205.
Fisckenscher A, Novins D. Gender differences and conduct disorder among American Indian adolescents in substance abuse treatment. J Psychoactive Drugs 2003; 35(1): 79-84.
Costello EJ, Erkanli A, Federman E, Angold A. Development of psychiatric comorbidity with substance abuse in adolescents: effects of timing and sex. J Clin Child Psychol 1999; 28(3): 298-311.
Hines LA, Morley KI, Mackie C, Lynskey M. Genetic and environmental interplay in adolescent substance use disorders. Curr Addict Rep 2015; 2(2): 122-9.
Goti Elejalde J, Diaz Hurtado R, Arango C. Patologia Dual: Protocolos de Intervencion. Adolescentes. Barcelona: EdikaMed, S.L.; 2014; 1-92.
Littlefield AK, Sher KJ. The multiple, distinct ways that personality contributes to alcohol use disorders. Soc Personal Psychol Compass 2010; 4(9): 767-82.
Schuckit MA, Windle M, Smith TL, et al. Searching for the full picture: Structural equation modeling in alcohol research. Alcohol Clin Exp Res 2006; 30(2): 194-202.
Tarter RE, Kirisci L, Mezzich A, et al. Neurobehavioral disinhibition in childhood predicts early age at onset of substance use disorder. Am J Psychiatry 2003; 160(6): 1078-85.
Mezzich AC, Tarter RE, Feske U, Kirisci L, McNamee RL, Day B-S. Assessment of risk for substance use disorder consequent to consumption of illegal drugs: Psychometric validation of the neurobehavior disinhibition trait. Psychol Addict Behav 2007; 21(4): 508-15.
Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry 2016; 3(8): 760-73.
Blum K, Braverman ER, Holder JM, et al. Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. J Psychoactive Drugs 2000; 32(Suppl: i-iv), 1-112.
Krueger R. The structure of common mental disorders. Arch Gen Psychiatry 1999; 56: 921-6.
Goti Elejalde J, Diaz Hurtado R, Arango C. Protocolos de Intervencion Patologia Dual Barcelona: EdikaMed, S.L.; 2016; 1- 36.
Kessler RC. The epidemiology of dual diagnosis. Biol Psychiatry 2004; 56(10): 730-7.
Sung M, Erkanli A, Angold A, Costello EJ. Effects of age at first substance use and psychiatric comorbidity on the development of substance use disorders. Drug Alcohol Depend 2004; 75(3): 287-99.
Black DW. The natural history of antisocial personality disorder. Can J Psychiatry 2015; 60(7): 309-14.
Black DW, Baumgard CH, Bell SEA. 16- to 45-year follow-up of 71 men with antisocial personality disorder. Compr Psychiatry 1995; 36(2): 130-40.
Libby AM, Riggs PD. Integrated substance use and mental health treatment for adolescents: aligning organizational and financial incentives. J Child Adolesc Psychopharmacol 2005; 15(5): 826-34.
Baker KD, Lubman DI, Cosgrave EM, et al. Impact of co-occurring substance use on 6 month outcomes for young people seeking mental health treatment. Aust N Z J Psychiatry 2007; 41(11): 896-902.
Rosenberg DR, Gershon S. Wiley InterScience (Online service) Pharmacotherapy of child and adolescent psychiatric disorders. John Wiley & Sons 2012.
Roncero C, Szerman N, Terán A, et al. Professionals’ perception on the management of patients with dual disorders. Patient Prefer Adherence 2016; 10: 1855-68.
Torales J, Riego V, Chavez E, et al. Trastorno por déficit de atención e hiperactividad dual en niños y adolescentes internados en un centro para el tratamiento de adicciones. An la Fac Ciencias Médicas 2014; 47(2): 33-40.
Martinez-Raga J, Knetcht C, Szerman N. Patologia dual: protocolos de intervención, TDAH. Edikamed 2012.
Riego Meyer V, Arce Ramírez A, Chávez ME, Recalde Berni S, Fernández P. Estudio piloto sobre la prevalencia de patología dual en niños y adolescentes internados en la Unidad de Desintoxicación Programada del Centro Nacional de Control de Adicciones en Asunción, Paraguay. Rev Paraguaya Psiquiatr 2013; 1: 24-31.
Torales J, González I, Castaldelli-Maia J, Waisman M, Ventriglio A. Early age of onset of drug use in Paraguayan children and adolescents: A public health challenge. Medicina Clínica y Social 2018; 2(2): 102-7.

© 2023 Bentham Science Publishers | Privacy Policy