Alcohol & Alcoholism Vol. 40, No. 2 © Medical Council on Alcohol 2005; all rights reserved
BOOK REVIEW
Managing the Dually Diagnosed Patient — Current Issues and Clinical Approaches, 2nd edn. By D. O'Connell and E. Beyer, The Haworth Press, New York. £33.00. 352 pgs. ISBN 0 7890 0877 7
This text, first published in 1990 and updated for this recent edition, was one of the original textbooks to discuss the management of patients with a dual diagnosis of mental illness and substance misuse. When first published, the number of books published on the subject would barely fill a small shelf. In the intervening twelve years, the texts on dual diagnoses could fill a library. Is there a need for a second edition? The answer is yes. The authors work at the Caron Foundation, a large inpatient addiction treatment centre in Pennsylvania, USA. The book is predominantly a text for addiction therapists to improve knowledge and therapeutic skills relating to dual diagnosis and mental health issues in their populations. However, I feel the book does have wider applications.The introductory sections cover the practical procedures in terms of admission, assessment, diagnosis and treatment in patients with dual diagnoses. There are also very useful clinical protocols which are used in the Caron Foundation for, e.g. the treatment of depression, anxiety, personality disorders and psychotic disorders in addicted populations. There is a good section on treatment adherence, which is a particular area of concern amongst those with co-morbid mental illness and substance misuse.
The two new chapters and in many ways the most successful chapters in this book, are in Section II, where the treatment in special populations is considered. I thought the section on females with dual diagnoses was excellent, pulling together a wealth of information in this area, drawing out the gender differences in presentation, with particular emphasis on dissociative disorders, eating disorders and expression in females, with a strong call for specialist treatment approaches in females with a dual diagnosis. The second chapter in this section is on the treatment of chemically dependent adolescents with a variety of dual diagnosis disorders, and again this is excellently written.
The final section reviews the impact of substance misuse in relation to a variety of psychiatric diagnoses, with explanations on the difficulty of assessing psychiatric symptoms in substance misusing populations and a review of specific treatments for a variety of conditions, including anxiety, depression, schizophrenia and personality disorder.
There is some tendency towards disorganisation and duplication, which I think could have benefited from some more careful editing, but overall I think this is an excellent book. For those who have the first edition, I would suggest obtaining this update because of the new review areas in gender and adolescence. I think this would be an excellent text, particularly for addiction therapists with limited general psychiatric experience, but it does have wider applications and gives some practical solutions to difficult clinical situations, which are appropriate for all professionals working in this area.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||