Chappel J N
Department of Psychiatry and Behavioral Sciences, University of Nevada School of Medicine, Reno 89557-0046.
J Psychoactive Drugs. 1993 Oct-Dec;25(4):293-300. doi: 10.1080/02791072.1993.10472286.
Treatment of dual diagnosis patients requires simultaneous treatment of the addictive and the mental disorders. Available data suggest that this does not happen often. In a survey of several psychiatric services, the unit chiefs reported that dual diagnoses were underreported, no plans were present for combined treatment, families were infrequently involved, and few referrals were made for combined treatment. There is a need for competent, experienced clinician teachers who have had positive experience with the treatment of dual disorders. The training of addiction and mental health professionals must include cooperation, understanding, and respect for each other. Cross-training is needed in chemotherapy, psychotherapy, abstinence from alcohol and other addictive drugs, 12-Step programs, spiritual issues, and milieu therapy. Negative attitudes and ignorance must be overcome for this training to take place. Faculty Fellow training programs have provided a beginning in this direction, but have so far involved few professional schools. Some examples of training with regard to referrals, prescribing, and psychotherapy are given. The importance of supervised clinical experience in treating dual diagnosis patients is emphasized. The provision of this experience provides a challenge to specialists in addiction medicine and addiction psychiatry.
双重诊断患者的治疗需要同时治疗成瘾性疾病和精神障碍。现有数据表明，这种情况并不常见。在对多家精神科服务机构的调查中，科室主任报告称双重诊断报告不足，没有联合治疗计划，很少让家庭参与，且很少进行联合治疗转诊。需要有能力、有经验且在双重障碍治疗方面有积极经验的临床教师。成瘾和心理健康专业人员的培训必须包括相互合作、理解和尊重。在化疗、心理治疗、戒酒及其他成瘾药物、12步康复计划、精神问题和环境治疗方面需要进行交叉培训。为了开展这种培训，必须克服消极态度和无知。教员研究员培训计划已在这个方向上迈出了第一步，但迄今为止涉及的专业学校很少。文中给出了一些关于转诊、开处方和心理治疗培训的例子。强调了在治疗双重诊断患者方面有监督的临床经验的重要性。提供这种经验对成瘾医学和成瘾精神病学专家构成了挑战。
