Drake R E, Bartels S J, Teague G B, Noordsy D L, Clark R E
New Hampshire-Dartmouth Psychiatric Research Center, Concord 03301.
J Nerv Ment Dis. 1993 Oct;181(10):606-11. doi: 10.1097/00005053-199310000-00006.
Substance abuse is the most common comorbid complication of severe mental illness. Current clinical research converges on several emerging principles of treatment that address the scope, pace, intensity, and structure of dual-diagnosis programs. They include a) assertive outreach to facilitate engagement and participation in substance abuse treatment, b) close monitoring to provide structure and social reinforcement, c) integrating substance abuse and mental health interventions in the same program, d) comprehensive, broad-based services to address other problems of adjustment, e) safe and protective living environments, f) flexibility of clinicians and programs, g) stage-wise treatment to ensure the appropriate timing of interventions, h) a longitudinal perspective that is congruent with the chronicity of dual disorders, and i) optimism.
物质滥用是严重精神疾病最常见的共病并发症。当前的临床研究集中在几个新出现的治疗原则上，这些原则涉及双重诊断项目的范围、节奏、强度和结构。它们包括：a）积极外展以促进参与物质滥用治疗；b）密切监测以提供结构和社会强化；c）在同一项目中整合物质滥用和心理健康干预措施；d）提供全面、基础广泛的服务以解决其他适应问题；e）安全和保护性的生活环境；f）临床医生和项目的灵活性；g）分阶段治疗以确保干预措施的适时性；h）与双重障碍的慢性病程相一致的纵向视角；以及i）乐观态度。
