Patients presenting with some type of chemical dependency (alcoholism, drug use/abuse, and so forth) are often given what is known as a dual diagnosis. A differential diagnosis consists of ruling out various alternative diagnoses, ruling out an etiological general medical condition, determining the specific primary disorder, and ultimately establishing boundaries between disorders or no disorders (DSM-IV-TR, 2008). A dual diagnosis, in contrast, refers to a case in which an individual presents with an emotional/psychiatric problem along with an alcohol or drug problem (Mental Health America, 2008).
Dual diagnoses are extremely common and the presence of the symptoms and antecedents of alcohol, sedative-hypnotics, stimulants, and hallucinogen abuse complicate the diagnosis of a psychiatric disorder by obscuring their causes and symptoms. At issue herein is the linkage between chemical dependency and anxiety, one of the more common disturbances of mood and affect suffered by individuals. Identification of the co-morbidity of such diagnoses and interventions will be presented.
According to Mental Health America (2008), it is difficult to determine whether or not substance abuse occurs before the onset of an emotional or psychiatric problem or as a consequence of that problem. Both problems must be treated simultaneously with the diagnosis of the comorbid psychiatric problem often determining treatment. The National Alliance on Mental Illness (2008) reported that substance abuse of all types complicates almost every aspect of care for the person with mental illness. Such individuals are difficult to engage in treatment. Diagnosis is difficult because it takes time to unravel the interacting effects of substance abuse and the mental illness. Dually diagnosed patients may find it difficult to be accommodated in their homes or in community residences. Violence is more common among the dually diagnosed population as are...