title: Managing patients with dual diagnosis in psychiatric practice.
abstract: OBJECTIVE
  To focus on recent research that may influence clinical practice in relation to patients with dual diagnosis disorders.
  
  
  RESULTS
  Harmful substance use is a heightened risk with bipolar disorder. Self-medication with substances of abuse for anxiety is linked with greater risk of developing anxiety disorders, particularly social anxiety disorder. Antisocial and schizotypal personality disorders were particularly linked with chronicity in substance use disorders. There are sex differences in responses to psychological approaches for dual disorders involving alcohol. Integrated dual diagnosis treatment for youth is not conclusive but shows promise. Online therapy is viable for adult patients with dual diagnosis. Structured interventions reduce the risk of opioid misuse amongst those with chronic pain, who are identified as at high risk.
  
  
  CONCLUSIONS
  We have confirmation that clinicians should be particularly vigilant in monitoring for substance use problems early in anxiety disorders and mood disorders and that certain personality disorders are linked with substance use chronicity. Practitioners can incorporate specific therapy approaches for dual disorders that appear to have advantages over treatment as usual.
authors.affiliation: Department of Psychiatry, Flinders University, Bedford Park, Australia. Michael.baigent@flinders.edu.au
authors.forename: Michael
authors.initials: M
authors.lastname: Baigent
mesh_terms: D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D009862:Online Systems; D011613:Psychotherapy / Q000379:methods*; D012651:Self Medication / Q000009:adverse effects; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*