Dual diagnosis: a review of etiological theories. Mueser, K T, Drake, R E, & Wallach, M A Addict. Behav., 23(6):717--734, November, 1998. 00000![Dual diagnosis: a review of etiological theories [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper abstract bibtex The etiology of the high prevalence of substance use disorders in patients with severe mental illness (schizophrenia or bipolar disorder) is unclear. We review the evidence of different theories of increased comorbidity, organized according to four general models: common factor models, secondary substance use disorder models, secondary psychiatric disorder models, and bidirectional models. Among common factor models, evidence suggests that antisocial personality disorder accounts for some increased comorbidity. Among secondary substance use disorder models, there is support for the supersensitivity model, which posits that biological vulnerability of psychiatric disorders results in sensitivity to small amounts of alcohol and drugs, leading to substance use disorders. There is minimal support for the self-medication model, but the accumulation of multiple risk factors related to mental illness, including dysphoria, may increase the risk of substance use disorder. Secondary psychiatric disorder models remain to be convincingly demonstrated. Bidirectional models have not been systematically examined. Further clarification of etiologic factors, including the identification of subtypes of dual diagnosis, may have implications for developing more effective prevention efforts and treatment.
@article{mueser_dual_1998,
title = {Dual diagnosis: a review of etiological theories},
volume = {23},
issn = {0306-4603},
url = {https://www.ncbi.nlm.nih.gov/pubmed/9801712},
abstract = {The etiology of the high prevalence of substance use disorders in patients
with severe mental illness (schizophrenia or bipolar disorder) is unclear.
We review the evidence of different theories of increased comorbidity,
organized according to four general models: common factor models,
secondary substance use disorder models, secondary psychiatric disorder
models, and bidirectional models. Among common factor models, evidence
suggests that antisocial personality disorder accounts for some increased
comorbidity. Among secondary substance use disorder models, there is
support for the supersensitivity model, which posits that biological
vulnerability of psychiatric disorders results in sensitivity to small
amounts of alcohol and drugs, leading to substance use disorders. There is
minimal support for the self-medication model, but the accumulation of
multiple risk factors related to mental illness, including dysphoria, may
increase the risk of substance use disorder. Secondary psychiatric
disorder models remain to be convincingly demonstrated. Bidirectional
models have not been systematically examined. Further clarification of
etiologic factors, including the identification of subtypes of dual
diagnosis, may have implications for developing more effective prevention
efforts and treatment.},
number = {6},
journal = {Addict. Behav.},
author = {Mueser, K T and Drake, R E and Wallach, M A},
month = nov,
year = {1998},
note = {00000},
keywords = {Sep 20 import, duplicate},
pages = {717--734}
}
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