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| Dysthymia and Substance Abuse: A New Perspective |
| Feature Articles - Dual Diagnosis | |
| Written by John W. McIlveen, MEd, Donald Mullaney, PhD, LCSW, | |
| Tuesday, 26 June 2007 | |
|
Mood disorders account for the vast majority of psychiatric disorders
that occur in the world. In fact, according to the Global Burden of
Disease study, which analyzed the impact of 107 major diseases on
morbidity and mortality, mood disorders are currently the world’s most
disabling condition (Ustun & Kessler, 2002). In substance abuse treatment facilities and the addictions field, in general, clinicians provide treatment to a significant number of patients dually diagnosed with both a substance abuse disorder and a co-morbid mood disorder. The ability to identify these conditions and incorporate these issues into a patient’s overall treatment plan can be essential to helping the patient achieve long-term sobriety. In the end, the overall goal of treatment should be to assist the patient in his or her early recovery process, thereby increasing the patient’s overall quality of life. Many patients, especially those with early onset mood disorders, may have developed substance dependency while attempting to self-medicate their conditions. By addressing co-occurring mood disorders in treatment and aftercare planning, we may be able to increase the patient’s chances of relapse-free early recovery. Identifying mood disorders It can be difficult to determine the nature of many mood disorders and their impact on a co-occurring substance abuse disorder. A thorough assessment and testing process is necessary to determine which patients exhibit traits and symptoms that may be linked to a specific mood disorder. However, even if a patient undergoes a comprehensive assessment and testing process, the presence of a significant mood disorder may go misdiagnosed, or not be diagnosed at all. Dysthymia is one such chronic mood disorder that may impact a patient’s overall treatment outcome, as well as play a role in his or her aftercare and recovery process. Dysthymia is a low-grade and chronic depressive condition that is distinguished from major depressive disorder largely on the basis of course. Dysthymia is an often misunderstood, under diagnosed and thus, under treated mood disorder. Researchers and clinicians estimate that from 3 percent to 6 percent of the general population suffers from dysthymia. However, one study shows that out of a sample of 30 patients who met DSM-III criteria for dysthymia, only 13 out of 30 were considered for a formal clinical diagnosis of the disorder (Shelton, Davidson, et. al., 1997). While other mood disorders may receive more attention, the awareness of the relationship between dysthymia and addictive disorders is also neglected. The results of a Google Internet search indicate the general lack of attention regarding this relationship. One reason for this may be that dysthymia is often thought of as a “low-grade” form of depression. Often, patients may not exhibit obvious physical signs, or show drastic decreases in everyday functioning. Sleep and appetite may not be impacted to a great degree. Evidence of dysthymic traits may be hard to interpret; often times, the patient may have shown signs of being “down,” or “glum,” for several years without the presence of a major depressive episode. Want to read the entire article? Don't miss out...Subscribe now to Counselor Magazine—or buy the single issue! It's easy. Just follow the links below:
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