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Dual diagnosis: An intriguing and actual nosographic issue too long neglected

Rivista di Psichiatria, ISSN: 2038-2502, Vol: 53, Issue: 3, Page: 154-159
2018
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Review Description

Background. The term "dual diagnosis" (DD) has been used in clinical practice for years. However, there is confusion about these medical cases, which consist in the presence of both a psychiatric disorder and a substance abuse disorder (in this case, alcohol). There are evidences that in the alcohol use disorder (AUD) population, 50.3% of patients had a psychiatric comorbidity during their lifetime. Nevertheless, to these days there are not any thorough guidelines for the management of these patients. A precise nosography would prevent delay in diagnosis and treatment and all the self-evident negative outcomes of those delays. Materials and methods. A literature search was performed in PubMed, Web of Science, and Scopus, including studies published between 1980 and 2015. Search terms were: "guidelines", "treatment", "comorbidity", "substance abuse", "alcohol", "dual-diagnosis", "etiopathogenesis", "outpatient", "inpatient", "unit", "diagnosis". Out of 1045 titles, 43 studies were included in this article for their relevance on definition and nosography of DD. Results. Taking into account the state of art available in the literature, we contributed to clarify the definition of DD in the alcohol addiction field. Clinical data confirm high prevalence of DD, and allow to better describe and understand the complex relationship between alcohol dependence and other psychiatric diseases. Conclusions.We believe that a clear nosographic framework and a precise diagnostic process are essential for a timely management of every case, using specific guidelines to standardize and improve clinical practice. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which introduces dimensional approach, could be a useful tool to improve diagnostic accuracy.

Bibliographic Details

Mario Vitali; Martino Mistretta; Bruna Scalese; Raffaella Porrari; Domenica Galli; Giovanna Coriale; Claudia Rotondo; Simona Solombrino; Maria Luisa Attilia; Francesca Sorbo; Giovanni Addolorato; Vincenzo Aliotta; Giovanni Alessandrini; Fabio Attilia; Giuseppe Barletta; Egidio Battaglia; Gemma Battagliese; Ida Capriglione; Valentina Carito; Onofrio Casciani; Pietro Casella; Mauro Ceccanti; Fernando Cesarini; Mauro Cibin; Rosaria Ciccarelli; Paola Ciolli; Angela Di Prinzio; Roberto Fagetti; Emanuela Falconi; Michele Federico; Giampiero Ferraguti; Marco Fiore; Daniela Fiorentino; Simona Gencarelli; Angelo Giuliani; Antonio Greco; Silvia Iannuzzi; Guido Intaschi; Luigi Janiri; Angela Lagrutta; Giuseppe La Torre; Giovanni Laviola; Roberta Ledda; Lorenzo Leggio; Claudio Leonardi; Anna Loffreda; Fabio Lugoboni; Simone Macrì; Rosanna Mancinelli; Massimo Marconi; Icro Maremmani; Marcello Maviglia; Marisa Patrizia Messina; Franco Montesano; Esterina Pascale; Michele Parisi; Roberta Perciballi; Fabiola Pisciotta; Giampaolo Spinnato; Alessandro Valchera; Valeria Zavan

Medicine

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