Thought disorders are characterized by a group of positive symptoms, such as hallucinations and delusions and negative symptoms such as mood swings, reduced motivation and social withdrawal. Loss of proper cognitive functioning is very common in such disorders. Recent studies have suggested that the first episode of psychosis in individuals found a 74% lifetime prevalence of a substance use disorder, with 62% of the sample presenting at baseline with current substance use.

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The most common types of thought disorders with the dual diagnosis of addiction are psychosis and schizophrenia. Smoking and the use of nicotine is quite common among the patients of thought disorders. Patients with certain disorder tend to smoke as a self medicating behavior to regulate their symptoms, but the drugs are usually found to interfere with the anti-psychotic medications.

It is difficult to determine whether those prone to psychosis are self-medicating initial symptoms, or whether they are drawn to substance use by factors unrelated to illness, such as personality traits. In addition, patterns of substance use before onset of illness may be indicative of other risk factors that are associated with lifestyle changes linked to the beginning of deterioration into psychosis and detrimental factors directly related to increased drug use.

The appearance of psychotic symptoms after the use of certain drugs can also be identified as drug-induced psychosis where the symptom of psychosis or schizophrenia usually disappear after maintaining abstinence from the drug for some time. The treatment of psychotic disorders with the dual diagnosis of addiction is a difficult and long procedure but not unachievable. Substance use during the course of a psychotic disorder may ultimately result to a relapse and difficulty in treatment. The most common and effective treatment of dual diagnosis is to work on both the disorders simultaneously.

By Samreen Masud
Clinical Psychologist

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