UW-Madison SOCWORK 453 - Psychiatric Comorbidity and the Family (7 pages)

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Psychiatric Comorbidity and the Family

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Psychiatric Comorbidity and the Family


Definitions of both comorbidity and dual diagnosis. And also information about psychiatric disorders and substance use. This is also a guest lecture with some information of how these things affect family.

Lecture number:
Lecture Note
University of Wisconsin, Madison
Socwork 453 - Alcohol and Other Drug Abuse
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Soc Work 453 Edition 1nd Lecture 18 Outline of Last Lecture I Trying to Communicate Effectively with people help someone II MI is NOT easy to learn III Speaker Listener Role IV Confrontation V What does it take Four Common Solutions VI Talking about benefits of change and concerns of not changing VII What is Motivational Interviewing a 4 processes b Does it work c Continuing to Learn Outline of Current Lecture II Overview III Announcements IV Comorbidity V Dual Diagnosis VI Treatment Implications VII Family Issues VIII Guest Speaker Current Lecture Psychiatric Comorbidity and the Family Special Guest Lecture with Bud Elliott Lynnette Kring Kim Kring Overview Definitions and Significance Comorbidity Dual Diagnosis Treatment Implications Psychiatric Disorders and Substance Use Family Issues Guest Speaker Panel Q A Announcements 2 extra credit questions today Special guests in lecture please prepare questions for the Q A section Comorbidity The presence of more than one diagnosable condition in an individual E g drug or alcohol use disorder plus depression Or can be used when ANY two disorders co occur a broader term Can be two things from the DSM Or two medical conditions Can be two anything Comorbidity doesn t mean just what we are talking about today it can be any two things 50 of people with substance use disorders have another psychiatric problem Reasons for this are because Same neurotransmitters are involved in both psychiatric disorders and substance use o Substance use can mimic mask or exacerbate symptoms of psychiatric disorders o Over time increases the complexity severity of one s problems In the reading the author was talking about the idea that when you get into a treatment setting you see around 60 80 of people have a psychiatric disorder Why higher in treatment People are more likely to get treatment if people have comorbidity Also issues are more likely to be severe or progressed a bit further if they end up in treatment It seems to be less severe if people are not in treatment Dopamine serotonin etc are all involved in psychiatric disorders and substance use disorders The way that they overlap and how they affect each other the two can mimic mask or exacerbate symptoms when people have both disorders Dual Diagnosis In AODA for the purpose of this course Used to specify when someone has a substance related disorder addiction disorder and a cooccurring major mental disorder that is independent from the addiction o E g alcohol dependence and bipolar disorder In Developmental Disability and Mental Health Used to described when someone has a developmental disability and another co occurring psychiatric disorder o E g intellectual disability and major depressive disorder Other complexity Polydrug abuse co occurring medical disorders triple diagnosis Some medical disorders can explain why some people may be taking multiple types of drugs Need to understand everything going on in the person to be able to understand everything Dual diagnosis with another diagnosis of HIV is known as triple diagnosis Triple Diagnosis has to be Substance use and a psychiatric disorder and then also HIV IClicker Question 1 According to Mueser 2006 which model has strong empirical support across all types of psychiatric conditions in explaining comorbidity for substance abuse Self medication hypothesis people use drugs to medicate their disorder Mueser said that this hypothesis was generally for anxiety disorders People sometimes take drugs that exacerbate their disorders It definitely does not work for all psychiatric symptoms Supersensitivity model When the disorder makes people more sensitive to the different types of drugs they are more vulnerable to the affects of the drugs and that means that the drugs have a much bigger affect on them than it would a more typical person This is opposite of the self medication model People who take cocaine who have a disorder might have different highs and don t come down from it easily This one hasn t shown the exact same support But they have shown that psychotic disorders have this affect Common factors model When there is one variable that predicts the use of both types of disorders Both psychiatric disorders and substance use disorders This model is particularly true for people who have antisocial personality disorder and conduct disorder This doesn t predict other disorders Bidirectional model Hasn t been studied much only for PTSD The onset of PTSD and use substances and that will make someone s PTSD symptoms worse which will cause people to use more substances and will make it even worse The answer was none of the above None have strong empirical support They were trying to say that none of these models explain how all psychiatric disorders work but they can be helpful in understanding how some psychiatric disorders will work for some people and how substance will act in some of these models Treatment Implications Substance use is complex Substance use can be a symptom of a disorder Bipolar disorder Antisocial Personality Disorder Understanding why the person is using or having a model is important because it can drive treatment Someone who is using substances of self medication to treat anxiety disorder or PTSD related anxiety vs someone who is exacerbating symptoms of anxiety or PTSD using substances How might you treat them differently Someone who is using some medication to treat anxiety disorder should have someone else to make sure they are taking it correctly Whereas someone who is exacerbating symptoms of anxiety of PTSD from substances maybe should be treated and told to try to stop taking the substances Self medicating means using drugs alcohol or other drugs in order to treat anxiety disorder Want to make sure they have support they need it may be completely untreated anxiety disorder Might want to get it managed and the symptoms managed in that type of situation IClicker 2 According to the McCrady reading when is family involvement most likely to be successful for a client with a substance use disorder A When there is absence of alcohol or other drug problems in the other family members B When the client comes to treatment after a crisis especially a crisis that threatens the integrity of the family unit C When several of the family members have severe substance use disorders D All of the above E Both a and b It is harder when several of the family members have severe substance use disorders Family Issues Why is it important to

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