Introduction—Key Readings in Addiction Psychiatry: Dual Diagnosis

This second volume in the Key Readings in Addiction Psychiatry series offers current reviews from journals that have published work focusing on the identification and treatment of co-occurring substance use and mental disorders.

Because of the dramatic negative clinical impact of under-identification of substance use disorders in mental health settings and mental disorders in addiction treatment settings, this compilation begins with four articles on vulnerability, screening, and differential diagnosis of substance use and comorbid mental disorders. The first article, Illicit psychoactive substance use, heavy use, abuse, and dependence in a U.S. population-based sample of male twins by Kendler et al., is a population epidemiologic study of male twins that examines the genetic and familial-environmental influences on risk for substance use. Genetic factors appear to account for most of the twin resemblance and heritability of heavy substance use, abuse, and dependence in men. The next two articles are from treatment-seeking samples that focus upon the etiology of psychiatric symptoms in the context of substance abuse. Toneatto et al. find in Diagnostic subgroups within a sample of comorbid substance abusers: correlates and characteristics that patients with substance-induced disorders and Axis II disorders tend to have more severe addiction histories. Compton et al. in Psychiatric disorders among drug dependent subjects: are they primary or secondary? confirm the high lifetime prevalence of co-occurring mental disorders among drug-dependent patients and importantly distinguish that the order of onset of these disorders varies depending upon the type of mental disorder, gender, and race. The last article in this group, Reliability and validity of screening instruments for drug and alcohol abuse in adults seeking evalu

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