PSYCH 275 FINAL: comorbidity – Flashcards
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comorbidity:
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Refers to the presence of two or more illnesses - medical or psychiatric conditions, including alcohol and other drug use disorders - in the same person
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interpretational difficulties
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Determining significance
Diagnostic Issues
Sampling Strategy
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consideration of comorbidity is important because
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Understanding etiology of alcohol and other psychiatric disorders
Understanding course of alcohol use disorders
Developing and testing integrated treatment approaches for AUD's co-occurring with other psychiatric disorders
Developing optimal policies for best serving affected individuals and reducing costs to society
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4 potential explanatory models
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(1) secondary alcoholism model, (2) secondary psychiatric disorder model, (3) common factor model, (4) bi directional model
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why do these disorders often co-occur?
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Overlapping genetic vulnerabilities. Predisposing genetic factors may make a person susceptible to both addiction and other mental disorders or to having a greater risk of a second disorder once the first appears.
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why do these disorders often co-occur (cont...)
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Overlapping environmental triggers. Stress, trauma (such as physical or sexual abuse), and early exposure to drugs are common environmental factors that can lead to addiction and other mental illnesses.
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why do these disorders often co-occur (cont...)
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Involvement of similar brain regions. Brain systems that respond to reward and stress, for example, are affected by drugs of abuse and may show abnormalities in patients with certain mental disorders.
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why do these disorders often co-occur (cont...)
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Drug use disorders and other mental illnesses are developmental disorders. That means they often begin in the teen years or even younger—periods when the brain experiences dramatic developmental changes. Early exposure to drugs of abuse may change the brain in ways that increase the risk for mental disorders. Also, early symptoms of a mental disorder may indicate an increased risk for later drug use.
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AUD and Anxiety three primary pathways
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the common factor model, the self medication model, the substance induced anxiety model
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the common factor model
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a third variable explains the co-occurrence of anxiety and AUDs
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the self medication model
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people consume alcohol to cope with anxiety disorders, leading to co-occurring AUDs
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the substance induced anxiety model
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AUDs lead to increased anxiety and vulnerability for co-occurring anxiety disorders
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AUD and schizophrenia
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Contributing Factors:
Biological Factors
Psychological and Social Factors
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Effects of AUD on Course and Outcome of Schizophrenia
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AUD associated w/ more severe course and poorer prognosis although comparisons are methodologically complex
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Treatment and Public Policy Implications
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Need to implement and test integrated treatment
Need to address policy barriers to increasing integrated treatment and evidence-based approaches
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treatment implications
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Use and evaluation of integrated treatment approaches is increasing but still rare
Pharmacological Treatment Approaches
Psychosocial Treatment Approaches
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policy implications
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Need to remove barriers to improved treatment access for comorbid individuals
"Therapeutic Catch-22's"
Integrated services through the use of multidisciplinary treatment teams that provide outreach, comprehensive, and stage-wise treatments