What is dual pathology?

The term dual pathology is used in the field of mental health to refer to patients who simultaneously have an addiction and a mental health disorder.

An addiction can apply to alcohol, pain killers, tobacco, or to cannabis, cocaine, amphetamines, opioids and other recreational and illegal substances. The addiction can also be an addiction to gambling or gaming.

Mental health disorders can range from anxiety disorders to mood or personality disorders, as well as conditions like schizophrenia, psychosis and ADHD.

How is a dual pathology diagnosed?

In order to identify a dual pathology, there are criteria from the diagnostic manuals of psychiatry (DSM) that differentiate between primary disorders (not associated with substance use or due to a disease with a recognised medical cause) and substance-induced disorders and their expected side effects that are the result of the consumption or withdrawal of a substance.

Symptoms of dual pathology

The most frequent symptoms of dual pathology are:

• High levels of impulsivity
• Aggression and violence
• Not respecting guidelines or rules
• Routine disorder in everyday life and paranoid thoughts
• Marginality and wandering​

In addition to the above are the symptoms associated with the addiction, be they related to alcohol abuse or substance overuse.

What are the causes of dual pathology?

There are different causes that can lead to a dual pathology, which include:

• Mental health disorder: suffering from a type of mental health disorder is a risk factor that can lead to an addiction.
• Substance use: one of the consequences of substance use is that it can lead to a dual pathology.
• Common causal elements: common vulnerability factors surrounding a person is another possible cause of dual pathology that can facilitate the appearance of a mental health disorder or addiction.
• Independent disorders: there are cases in which no cause-effect can be found between an addiction and a mental health disorder.

Can it be prevented?

Prevention focuses on avoiding risk factors that may lead to an addiction. For example, avoiding cocaine use will help if the patient suffers from a mental health disorder.

Adhering to the treatment plan prescribed by the specialist is another preventive measure, as well as following therapeutic and rehabilitative activities as advised. A suitable and supportive work and living environment is another measure that can favour the prevention of dual pathology.

Treatments for dual pathology

It’s recommended that patients receive combined treatment, including treatment for the addiction, along with psychiatric and psychological mental health treatment.