Chapter 2

Diagnostic Subgroups within a Sample of Comorbid Substance Abusers

Correlates and Characteristics

Tony Toneatto, Ph.D.

Juan Carlos Negrete, M.D.

Kim Calderwood, M.S.W.

With the accumulating evidence of considerable psychiatric comorbidity among treatment-seeking substance abusers, there is a need for a better characterization of the phenomenological heterogeneity of this population. Such knowledge may be significant in the assessment of substance use and psychiatric symptoms, planning of treatment, evaluating prognosis, and preventing relapse. Although the research literature has focused primarily on establishing a relationship between psychiatric and substance use disorder, 1,2 relatively less attention has been paid to describing subsets of comorbid populations along clinical, psychosocial, and demographic characteristics. Mowbray et al. 3 have pointed out that insufficient information is gathered about different subtypes of psychiatric comorbidity among substance abusers to effectively plan treatment services. They suggest that more descriptive research is needed on the clinical, demographic, and social adjustment characteristics of comorbid populations in order to portray their heterogeneity and better select treatment strategies.

In a sample of male alcoholics with psychiatric disorders, Penick and colleagues 4 found that a substantial proportion qualified for multiple psychiatric diagnoses. Furthermore, these psychiatric disorders did not cluster randomly. For

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