This issue of the Journal of Dual Diagnosis includes eight articles delineating many aspects of the fascinating interplay of the co-occurrence of substance use and psychiatric disorders and the many approaches being taken to understand and treat such dual disorder conditions.
Karapareddy et al., in a scholarly review, set out to determine the difference in existing treatment models for co-occurring mental health and substance use disorders, with an eye toward policy recommendations. They conclude that while the literature is limited, and conclusions must be tentative, integrated models of care seem most able to achieve both reductions in substance use and improvement in mental health.
Bhalla et al. report on patients served within the Veterans Administration who have both posttraumatic stress disorder (PTSD) and substance use disorder and indicate that, prior to treatment, the use of a greater number of substances is associated with more severe PTSD symptoms (as well as more days of substance use). And at follow-up after treatment, the association, although somewhat attenuated, still was detected.
Jane et al. address the question of whether the amino acid glycine could be helpful for patients with schizophrenia and alcohol dependence. The study is based on other data indicating the possible benefit of glycine, with its action on the NMDA receptor, on both symptoms of schizophrenia and substance use independently. The results do not show a statistical benefit of the use of glycine, although there was a suggestion of a decrease in symptoms of schizophrenia that might have become significant with a larger sample. Other studies appear warranted.
Hass et al. report on posttraumatic stress symptoms (PTSS), alcohol misuse, and anxiety sensitivity in a group of Black college students. They conclude that anxiety sensitivity provides an indirect effect on alcohol use through PTSS—which are associated with higher levels of alcohol use. In another study of college students, Eddinger et al. assess the effect of a history of losses and alcohol use. They report an association of a history of sudden, violent loss with alcohol use.
D’Souza et al. note that low resting high frequency– heart rate variability is associated with drug and alcohol symptom severity in those with PTSD and substance use disorder.
Potvin et al. describe a neuroimaging study of connectivity in patients with schizophrenia who were tobacco smokers as compared to smokers without schizophrenia. They report that those with schizophrenia demonstrated an increased connectivity between the nucleus accumbens and areas of the default mode network.
Last, in a pilot study of the use of dialectical behavior therapy (DBT) with skills training for smoking cessation and opioid relapse prevention during methadone treatment, Cooperman et al. note that such a treatment approach is feasible in this population. They call for a randomized trial to test whether DBT skills training can be a helpful intervention.