Understanding Comorbidity

By Dr. Silvernail, PhD, LMHC, CAP

Understanding Comorbidity

Understanding Comorbidity, the term “comorbidity” refers to a condition in which both mental illness and substance use disorder, such as alcohol dependency and depression, coexist in a person. For example, people with substance use may suffer from cocaine dependency and antisocial personality disorder.

The terms “co-occurring” and “dual disorders” are related to comorbidity. Individuals with co-occurring disorders have a higher rate of dropping out of preventive treatments. Also, dual-diagnosis clients find it difficult to comply with treatment requirements.

People with dual disorders are at high risk for chronic relapse, emergency hospitalizations, vocational problems, family problems, homelessness, suicide, violence, sexual and physical victimization, incarceration, and early death. Therefore, they require an integrated treatment program—combined treatment for mental illness and substance use is provided by the same clinician or treatment team. The clinician or treatment team uses medication in conjunction with case management and intensive therapy to treat people suffering from comorbidity.

Comorbidity remains one of the most poorly understood areas in the field of substance abuse and treatment services. Although surveillance studies have documented the patterns of association between substance use disorders and mental disorders and established that these associations are not due to chance, much remains to be understood about the etiology of comorbid conditions.

Interdisciplinary research efforts may yield new insights because questions about comorbidity range from problems in molecular genetics to the social environment and public policy arena.

Most pressing is the need for further research on integrated treatment approaches for persons with dual diagnoses, such as substance abuse and severe mental illness. The integrated treatment model promises help for individuals suffering from comorbidity. Ancillary Services (overlay services) are encouraged, the provision of ancillary services should be based on client needs as determined by the treatment plan and treatment plan.

SAMSHA.org has a wonderful resource manual for treating co-occurring disorders http://www.comorbidity.org.au/node/424

Dr. Silvernail, PhD, LMHC, CAP has built a reputation for being one of the best professional consultants in the field. A Licensed Mental Health Counselor with a PhD in Psychology and Addictionology Counseling, she has over 26 years of experience developing and implementing quality educational programs in the field of addictions and mental health treatment. Dr. Silvernail is the CEO of Silvernail Consultant Services, (www.SilvernailConsultantServices.com) and currently is the Clinical Supervisor for Total Recovery Now in Lake Worth. (www.TotalRecoveryNow.com). With such a high standing reputation, she has been named the FMHCA President Elect (2013).