Contributors.
Foreword.
Part 1 Contemporary Context.
1 Definition, Recognition and Assessment (Olive
McKeown).
Introduction.
Definition and terminology.
General considerations in the recognition and assessment of dual
diagnosis.
How significant is the problem of dual diagnosis?
Recognition and assessment.
Hypotheses.
Conclusion.
2 Explanatory Models for Dual Diagnosis (Peter Phillips and
Sonia Johnson).
Introduction.
Is substance misuse more prevalent among people with psychotic
illnesses than in the general population?
Which problem generally develops first in dual diagnosis?
Does dual diagnosis have a neurobiological basis?
Is dual diagnosis mediated by personality disorder?
Do people with schizophrenia use substances as a form of
self-medication?
Have changes in the care and social circumstances of people with
schizophrenia, particularly deinstitutionalisation, led to a rise
in substance misuse in this population?
Do the social situations and social difficulties of people with
schizophrenia lead to substance use?
Do people with schizophrenia tend to begin using drugs and
alcohol within mental health service settings or in the company of
other users of such services?
Conclusion.
3 Consumer Perspectives (David Webb).
Introduction.
Human experience and medicine.
Diagnosis, treatment and human rights.
Two worlds.
Significant contrasts.
Diagnosis.
Treatment.
Dual diagnosis and policy.
Conclusion.
Part 2 Common Presentations and Special Populations.
4 Risk Assessment and Dual Diagnosis (Lisa Reynolds and Jenny
Oates).
Introduction.
Clinical risk assessment.
Principles of risk assessment and management.
The process of risk assessment and management.
Conclusion.
5 Reducing Drug-Related Harm Among Mentally Ill People (Peter
Phillips).
Introduction.
Interventions and approaches.
Harm reduction.
Using harm reduction approaches with mentally ill
individuals.
Dual diagnosis and harm reduction: the future?
Conclusion.
6 Motivational Interviewing (Chris Glover).
Introduction.
What is MI?
Conclusion.
7 Psychological Interventions (Patrick Callaghan and David
Jones).
Introduction.
The nature and type of psychological interventions.
The evidence for psychological interventions in dual
diagnosis.
Individual therapies.
Group therapies.
Cognitive behaviour therapy and relapse prevention.
Family interventions.
Contingency management.
Conclusion.
8 Alcohol and Mood Disorders (Julie Attenborough).
Introduction.
Harm, alcohol and mental illness.
Presentation: alcohol and mental illness.
Medication and dual diagnosis.
Conclusion.
9 Polysubstance Use and Personality Disorder (Simon
McArdle).
Introduction.
Prevalence.
Service delivery.
What is personality disorder?
Treatment and intervention approaches.
Assessment.
Stages of change.
Therapeutic principles.
Conclusion.
10 Older People and Dual Diagnosis (Sue Excell).
Introduction.
An increasing population.
Policy framework.
Media representation of information on alcohol.
Perception of old age.
Alcohol use in older people.
Complications of excessive alcohol use.
Assessment and screening.
Under-reporting.
Over-the-counter medication (OTC).
Prescribed medication.
Conclusion.
11 Stimulant Use and Psychosis (Lorna Saunder).
Introduction.
Stimulant use in the United Kingdom.
Stimulants and drug-induced psychosis.
Stimulants and mental illness.
Stimulants and their use by people with existing psychotic
illnesses.
Implications for practice.
Conclusion.
12 Women and Dual Diagnosis (Julie Winnington).
Introduction.
Gender differences in dual diagnosis.
The impact of dual diagnosis on families.
Dual diagnosis and domestic violence.
Dual diagnosis within the female prison service.
A case for gender-specific services.
Conclusion.
13 Drug-Induced Psychosis (Hulya Bilgin, Murat Soncul
and Peter Phillips).
Introduction.
Dual diagnosis: a common problem.
The relationship between substance use and psychosis:
aetiology.
A model of relationships between psychotic illness and drug and
alcohol use.
Conclusion.
14 Cannabis Use and Psychosis (Liz Hughes).
Introduction.
What is cannabis?
How is it used?
Legal issues.
How it affects the user.
Psychological effects.
Physical effects.
Safety issues.
The links between cannabis and psychosis.
Interventions for cannabis and psychosis.
Conclusion.
15 Methamphetamine and Mental Health (Melinda
Campopiano).
Introduction.
Initiation and continuation of methamphetamine use: missed
opportunities.
Methamphetamine and mental health: intoxication, withdrawal and
psychiatric illness.
Methamphetamine addiction: treatment and outcomes.
Conclusion.
Acknowledgements.
16 Public Health and Dual Diagnosis (Linda Bailey).
Introduction.
Epidemiology.
Causal relationship.
Treatment for BBV.
Other co-infections.
Conclusion.
17 Comorbidity or Complexity: A Primary Care Perspective on Dual
Diagnosis (John Budd).
Introduction.
Policy framework.
Epidemiology.
Key features of general practice care.
Physical health care.
Mental health and substance misuse care.
Limitations and potential in primary care.
Conclusion.
Part 3 International Perspectives, Policy and
Development.
18 Dual Diagnosis ? North America (Theodora Sirota and
Kathleen Leo).
Introduction.
Prevalence.
Historical context.
Socio-cultural and public policy considerations.
Approaches to treatment.
Research.
Issues and challenges.
Conclusion.
19 Dual Diagnosis ? Australasia (Gary Croton).
Introduction.
Drivers for system change.
Consumer and carer demand.
Prevalence.
Harms and unwanted outcomes strongly associated with dual
diagnosis.
Opportunity to provide more effective treatment of
?target? disorders via improved recognition and more
effective responses to co-occurring disorders.
Barriers to better outcomes for persons with dual diagnosis.
Indigenous Australians.
Rural and remote regions of Australia.
Australia?s responses to dual diagnosis.
Structure of the Australian health care system.
National level responses to dual diagnosis.
The National Comorbidity Initiative.
Improved Services for People with Drug and Alcohol Problems and
Mental Illness Measure.
?Can Do? ? Managing Mental Health and
Substance Use in General.
Practice.
Headspace.
State level responses to dual diagnosis.
Conclusion.
20 Dual Diagnosis ? Europe (Jane Salvage and Rob
Keukens).
Introduction.
The historical and social context.
Elements of dual diagnosis in the region.
Alcohol.
Other psychoactive substances.
Care and treatment responses.
Problems and solutions.
Conclusion.
21 Commissioning Services for Users with Dual Diagnosis
(Sharon Dennis).
Introduction.
Background.
The history of commissioning.
Implications for commissioning dual diagnosis services.
Conclusion.
22 Practice, Research and Education Development (Kevin
Gournay).
Introduction.
Research.
Education development.
Practice.
Conclusion.
Index.
