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Abstract

Mentally ill substance abusers have two illnesses. The first is the substance abuse pattern, one that may involve signs of physical dependency including tolerance and withdrawal, and that often creates problems in employment, relationships, and legal areas. Second, this group suffers more severe emotional and cognitive disturbances than those one ordinarily sees in people who abuse substances. The overlap between the two illnesses often leads to diagnostic confusion and complicates treatment strategies.

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References

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders ( 3rd Edition ). Washington, DC: Author.

    Google Scholar 

  • Bohman, M., Sigvardsson, S., & Cloninger, C. W. (1981). Maternal inheritance of alcohol abuse: Cross-fostering analysis of adopted women. Archives of General Psychiatry, 38, 965–969.

    Article  PubMed  Google Scholar 

  • Bowen, R. C., Cipynyk, D., D’Arcy, C., & Keegan, D. (1984). Alcoholism, anxiety disorders, and agoraphobia. Alcoholism: Clinical and Experimental Research, 8, 48–50.

    Article  Google Scholar 

  • Byck, R. (1974). Cocaine papers by Sigmund Freud. New York: New American Library.

    Google Scholar 

  • Carlin, P. L., Holgate, G. W. R. C., Wilkinson, D. A., & Rankin, J. G. (1978). Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomography scans. Science, 200, 1076–1078.

    Article  Google Scholar 

  • Cermak, T. (1984). Children of alcoholics and the case for a new diagnostic category of codependency. Alcohol Health and Research World, 5, 38–42.

    Google Scholar 

  • Cermak, T. L., & Brown, S. (1982). Interactional group therapy with the adult children of alcoholics. International Journal of Group Psychotherapy, 32, 375–389.

    PubMed  Google Scholar 

  • Cloninger, C. R., Bohman, M., & Sigvardsson, S. (1981). Inheritance of alcohol abuse: Cross-fostering analysis of adopted men. Archives of General Psychiatry, 38, 861–868.

    Article  PubMed  Google Scholar 

  • Comfort, A. (1977). Morphine as an antipsychotic: Relevance of a 19th century therapeutic fashion. Lancet, 2, 448–449.

    Article  PubMed  Google Scholar 

  • Cronson, A. J., & Flemenbaum, A. (1978). Antagonism of cocaine highs by lithium. American Journal of Psychiatry, 135, 856–857.

    PubMed  Google Scholar 

  • Dackis, C. A., Bailey, J., Pottash, A. L. C., Stuckey, R. F., Extein, I. L., & Gold, M. S. (1984). Specificity of the DST and the TRH test for major depression in alcoholics. American Journal of Psychiatry, 5, 680–683.

    Google Scholar 

  • Dackis, C. A., Gold, M. S., Davies, R. K., & Sweeney, D. R. (1985–86). Bromocriptime treatment for cocaine abuse: The dopamine depletion hypothesis. International Journal of Psychiatry in Medicine, 15, 125–135.

    Google Scholar 

  • Dave, M., & Wanck, B. (1985). Depression in alcoholics: Implications for treatment. Journal of the American Medical Association, 254, 2–31.

    Article  Google Scholar 

  • Dietrich, R. A. (1977). Plasmalogen content of cerebellum samples from alcoholic and nonalcoholic humans. Alcoholism: Clinical and Experimental Research, 1, 11–32.

    Google Scholar 

  • Ebin, D. (1961). The drug experience; first-person accounts of addicts, writers, scientists and others. New York: Grove Press.

    Google Scholar 

  • Fischer, D. E., Halikas, J. A., Baker, J. W., & Smith, R. L. (1976). Frequency and patterns of drug abuse in psychiatric patients. Diseases of the Nervous System, 36, 550–553.

    Google Scholar 

  • Fowler, R. C., Liskow, B. I., & Tanna, V. L. (1977). Psychiatric illness and alcoholism. Alcoholism, 1, 125–128.

    PubMed  Google Scholar 

  • Gawin, F. H., & Kleber, H. D. (1984). Cocaine abuse treatment: Open pilot trial with desipramine and lithium carbonate. Archives of General Psychiatry, 41, 903–909.

    Article  PubMed  Google Scholar 

  • Gawin, F. H., & Kleber, H. D. (1986). Abstinance symptomatology and psychiatric diagnosis in cocaine abusers: Clinical observations. Archives of General Psychiatry, 43, 107–113.

    Article  PubMed  Google Scholar 

  • Gold, M. S., Pottash, A. C., Sweeney, D., Martin, D., & Extein, I. (1982). Antimanic, antidepressant, and antipanic effects of opiates: Clinical, neuroanatomical, and biochemical evidence. Annals of the New York Academy of Sciences, 398, 140–150.

    Article  PubMed  Google Scholar 

  • Gold, M. S., Redmond, D. E., Donabedian, R. K., Goodwin, F. K., & Extein, I. (1978). Increase in serum prolactin by exogenous and endogenous opiates: Evidence for antidopamine and antipsychotic effects. American Journal of Psychiatry, 135, 1415–1416.

    PubMed  Google Scholar 

  • Goodwin, D. W. (1983). The genetics of alcoholism. Hospital and Community Psychiatry, 34, 1031–1034.

    PubMed  Google Scholar 

  • Gravitz, H. L., & Bowden, J. D. (1984). Therapeutic issues of adult children of alcoholics. Alcohol Health and Research World, 6, 25–42.

    Google Scholar 

  • Greenstein, R. A., Arndt, I. C., McLellan, A. T., O’Brien, C. P., & Evans, B. (1984). Naltrexone: A clinical perspective. Journal of Clinical Psychiatry, 45 (92), 25–28.

    PubMed  Google Scholar 

  • Hesselbrock, M. N., Meyer, R. E., & Keener, J. J. (1985). Psychopathology in hospitalized alcoholics. Archives of General Psychiatry, 42, 1050–1055.

    Article  PubMed  Google Scholar 

  • Jaffe, A. (1978). Reform in American medical science: The inebriety movement and the origins of the psychological disease theory of addiction, 1870–1920. British Journal of Addiction, 2, 139–147.

    Article  Google Scholar 

  • James, W. (1961). The varieties of religious experience: A study in human nature. New York: Collier Books.

    Google Scholar 

  • Jellinek, E. M. (1960). The disease concept of alcoholism. New Haven, CT: College and University Press.

    Book  Google Scholar 

  • Keeler, M. H., Taylor, C. I., & Miller, W. C. (1979). Are all recently detoxified alcoholics depressed? American Psychiatric Association, 4, 586–588.

    Google Scholar 

  • Keller, M. B., Kierman, G. L., Lavori, P. W., Coryell, W., Endicott, J., & Taylor, J. (1984). Long term outcome of episodes of major depression. Journal of the American Medical Association, 252, 788–792.

    Article  PubMed  Google Scholar 

  • Khantzian, E. J. (1975). Self selection and progression in drug dependence. Psychiatry Digest, 10, 19–22.

    Google Scholar 

  • Khantzian, E. J. (1983). An extreme case of cocaine dependence and marked improvement with methylphenidate treatment. American Journal of Psychiatry, 140, 784–785.

    Google Scholar 

  • Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. American Journal of Psychiatry, 142, 1259–1264.

    PubMed  Google Scholar 

  • Khantzian, E. J., & Treece, C. (1985). DSM-III psychiatric diagnosis of narcotic addicts. Archives of General Psychiatry, 42, 1067–1071.

    Article  PubMed  Google Scholar 

  • Kleber, H. D., & Gawin, F. H. (1984). The spectrum of cocaine abuse and its treatment. Journal of Clinical Psychiatry, 45 (122), 18–23.

    Google Scholar 

  • Kofoed, L., Kania, J., Walsh, T., & Atkinson, R. (1986). Outpatient treatment of patients with substance abuse and coexisting psychiatric disorders. American Journal of Psychiatry, 7, 867–872.

    Google Scholar 

  • Kramer, J. C., Fischman, V. S., & Littlefield, D. C. (1967). Amphetamine abuse pattern and effects of high doses taken intravenously. Journal of the American Medical Association, 201, 305–309.

    Article  PubMed  Google Scholar 

  • Liddon, S. C., and Satran, R. (1967). Disulfiram (Antabuse) psychosis. American Journal of Psychiatry, 123, 1284–1289.

    PubMed  Google Scholar 

  • Milkman, H., & Frosch, W. A. (1973). On the preferential abuse of heroin and amphetamine. Journal of Nervous and Mental Disease, 156, 242–248.

    Article  PubMed  Google Scholar 

  • Mullaney, J. A., & Trippett, C. (1979). Alcohol dependence and phobias: Clinical description and relevance: British Journal of Psychiatry, 135, 563–573.

    Article  Google Scholar 

  • Munjack, D. J., & Moss, H. B. (1981). Affective disorder and alcoholism in families of agoraphobics. Archives of General Psychiatry, 38, 868–871.

    Article  Google Scholar 

  • Musto, D. (1986, June 11). Lessons of the first cocaine epidemic. The Wall Street Journal.

    Google Scholar 

  • Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C. E., III, Leaf, P., Orvaschel, H., Anthony, J. C., Boyd, J. H., Burke, J., Jr., Kramer, M., & Stoltzman, R. (1984). Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry, 4, 959–967.

    Article  Google Scholar 

  • Nicholson, B., & Treece, C. (1981). Object relations and differential treatment response to methadone maintenance. Journal of Nervous and Mental Diseases, 169, 424–429.

    Article  Google Scholar 

  • Powell, B. J., Penick, E. C., Othner, E., Bingham, S. F., & Rice, A. S. (1982). Prevalence of additional psychiatric syndromes among male alcoholics. Journal of Clinical Psychiatry, 43, 404–407.

    PubMed  Google Scholar 

  • Rounsaville, B. J., Weissman, M. M., Kleber, H., & Wilber, D. (1982). Heterogeneity of psychiatric diagnosis in treated opiate addicts. Archives of General Psychiatry, 39, 161–166.

    Article  PubMed  Google Scholar 

  • Schuckit, M. (1983). Alcoholic patients with secondary depression. American Journal of Psychiatry, 6, 711–714.

    Google Scholar 

  • Schuckit, M. A. (1985). The clinical implications of primary diagnostic groups among alcoholics. Archives of General Psychiatry, 11, 1043–1049.

    Article  Google Scholar 

  • Schuckit, M. A. (1986). Genetic and clinical implications of alcoholism and affective disorder. American Journal of Psychiatry, 143, 140–147.

    PubMed  Google Scholar 

  • Seixas, F. A. (1980). A historical perspective of alcoholism. In: E. Gottheil, A. T. McLellan, & K. A. Druley (Eds.), Substance abuse and psychiatric illness: Proceedings of the second annual Coatesville-Jefferson conference on addition (pp. 76–84 ). New York: Pergamon Press.

    Google Scholar 

  • Smail, P., Stockwell, T., Canter, S., & Hodgson, R. (1984). Alcohol dependence and phobic anxiety states: 1. A prevalence study. British Journal of Psychiatry, 144, 53–57.

    Article  PubMed  Google Scholar 

  • Stockwell, T., Smail, P., Hodgson, R., & Canter, S. (1984). Alcohol dependence and phobic anxiety states: 2. A retrospective study. British Journal of Psychiatry, 144, 58–63.

    Article  PubMed  Google Scholar 

  • Svanum, S., & Schladenhauffen, J. (1986). Lifetime and recent alcoholic consumption among male alcoholics. Journal of Nervous and Mental Disease, 4, 214–220.

    Article  Google Scholar 

  • Thomsen, R. (1975). Bill W. New York: Harper & Row.

    Google Scholar 

  • Weingold, H. P., Lachin, J. M., Bell, A. H., & Coxe, R. C. (1968). Depression as a symptom of alcoholism: Search for a phenomenon. Journal of Abnormal Psychology, 73, 195–197.

    Article  PubMed  Google Scholar 

  • Weiss, K. J., & Rosenberg, D. J. (1985). Prevalence of anxiety disorder among alcoholics. Journal of Clinical Psychiatry, 46, 3–5.

    PubMed  Google Scholar 

  • Wieder, H., & Kaplan, E. H. (1969). Drug use in adolescents: Psychodynamic meaning and pharmacogenic effect. Psychoanalytic Study of Childhood, 24, 399–413.

    Google Scholar 

  • Woititz, J. G. (1983). Adult children of alcoholics. Pompano Beach, FL: Health Communications.

    Google Scholar 

  • Woody, G. E., Luborsky, L., McLellan, A. T., O’Brien, C. P., Beck, A. T., Blaine, J., Herman, I., & Hole, A. (1983). Psychotherapy for opiate addicts: Does it help? Archives of General Psychiatry, 40, 639–645.

    Article  PubMed  Google Scholar 

  • Woody, G. E., McLellan, A. T., Luborsky, L., O’Brien, C. P., Blaine, J., Fox, S., Herman, I., & Beck, A. T. (1984). Severity of psychiatric symptoms as a predictor of benefits from psychotherapy: The Veterans Administration-Penn study. American Journal of Psychiatry, 141, 1172–1177.

    PubMed  Google Scholar 

  • Wren, J. C., Kline, N. S., Cooper, T. B., Varga, E., & Canal, O. (1974). Evaluation of lithium therapy in chronic alcoholism. Clinical Medicine, 81, 33–36.

    Google Scholar 

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Wanck, B. (1990). Mentally Ill Substance Abusers. In: Thase, M.E., Edelstein, B.A., Hersen, M. (eds) Handbook of Outpatient Treatment of Adults. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0894-0_25

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  • DOI: https://doi.org/10.1007/978-1-4899-0894-0_25

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