Duijkers Judith C L M, Vissers Constance Th W M, Egger Jos I M
Centre of Excellence for Korsakoff and Alcohol Related Cognitive Dysfunctions/Addiction Care, Vincent van Gogh Institute for PsychiatryVenray, Netherlands; Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands.
Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands; Kentalis Academy, Royal Dutch KentalisSint-Michielsgestel, Netherlands.
Front Psychol. 2016 Jun 28;7:979. doi: 10.3389/fpsyg.2016.00979. eCollection 2016.
In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one's behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one's self-regulative abilities.
在心理健康领域，“双重诊断”一词用于指物质使用障碍（SUD）与另一种精神障碍同时出现的情况。这些共病障碍可能有共同的病因，并且会导致彼此的症状表现加剧。双重诊断对健康和社会构成威胁，与成瘾相关行为的复发以及破坏性的生活方式有关。这是由于持续无法控制冲动以及在日常生活中维持不充分的自我调节行为。因此，执行功能的几个方面，如抑制、转换和更新过程，在双重诊断中似乎受到损害。目前，执行（功能）障碍甚至被视为大多数精神障碍共同的潜在关键组成部分。然而，关于双重诊断中执行功能各个方面的研究数量有限。在本综述中，对双重诊断中执行功能的各个方面进行了系统概述，力求勾勒出双重诊断患者的典型特征。从实证结果来看，对于患有物质使用障碍并伴有精神分裂症、双相情感障碍或B类人格障碍的患者，抑制和转换过程似乎受到损害。涉及双重诊断更新过程任务的研究有限。需要更多深入研究这些执行功能的全部多样性的研究，以强化这些发现。对构成个体行为基础且与诊断分类相关的优缺点特征有详细了解，可导致量身定制的评估和治疗指征，指出在自我调节能力方面哪些方面需要关注和/或训练。
