Comorbid mental disorders and substance use disorders: epidemiology, prevention and treatment

This monograph provides the evidence base and the beginning of a common language to address the complex issues around comorbidity.

Page last updated: 2003

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Edited by Maree Teesson and Heather Proudfoot

National Drug and Alcohol Research Centre
University of New South Wales
Sydney, Australia

Funded by the Australian Government Department of Health and Ageing, Australia

ISBN 0 642 82 424 X

Publication approval number: 3415

Additional copies can be obtained from the Population Health Division, Department of Health and Ageing, on (02) 6289 4524.

Acknowledgements
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Contributing authors
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Acknowledgements

This monograph would not have been possible without the support of many individuals and organisations. Numerous individuals and organisations wrote to the Australian Government Department of Health and Ageing to raise the issue. Others spoke about the issue in public and private forums. Carers, consumers, academics, service providers and administrators all made concerted attempts to bring the issue forward.

The National Comorbidity Project also owes its existence to the foresight of Ms Cheryl Wilson, former Director of the Illicit Drugs Section, Drug Strategy Branch and Ms Leonie Young, former Director of the Promotion and Prevention Section, Health Priorities and Suicide Prevention Branch. They were willing to bring their different perspectives on the issue to the same table. Professors Scott Henderson and Ian Webster guided early discussions.

This monograph is funded by a grant to the National Drug and Alcohol Research Centre from the Australian Government Department of Health and Ageing.

Copyright statements

Paper-based publications

Commonwealth of Australia 2003
This work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice an all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health and Ageing, GPO Box 9848, Canberra ACT 2601, or by e-mail to copyright at copyright@health.gov.au.

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Commonwealth of Australia 2003

This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice an all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health and Ageing, GPO Box 9848, Canberra ACT 2601, or by e-mail to copyright at copyright@health.gov.au.
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Disclaimer

The opinions expressed in this document are those of the authors and are not necessarily those of the Australian Government. This document is designed to provide information to assist policy and program development in government and non-government organisations.

Contributing authors

Gavin Andrews is Professor of Psychiatry at the University of New South Wales and Director of the World Health Organisation Centre for Evidence in Health Care Policy, Sydney. He is influential in setting the health care research agenda in Australia and recently directed the Australian National Survey of Mental Health and Wellbeing. He is the author of numerous research publications and a number of books.

Erin Atkinson is a clinical psychologist who has worked with a range of child, adolescent and family mental health problems. She has researched and published in the area of the effects of marital problems on children's mental health and is currently completing her PhD at Griffith University in Brisbane.

Amanda Baker is a Senior Lecturer in Psychology at the University of Newcastle, New South Wales. She has conducted research into the treatment of schizophrenia and schizophrenia comorbid with substance use disorders. Her recent work includes the treatment of amphetamine dependence.

Elizabeth Brewin is a research nurse at the Institute of Psychiatry, Kings College, London. In the past, she has been involved in development of a clinical service for people with comorbid mental health and substance use disorders, and in her current post has been involved in two major randomised controlled trials of training in interventions for this group. She has also been course leader for four years for the first course to be validated on dual diagnosis interventions in the UK.

Mark Dadds is a Professor of Clinical Psychology at The University of New South Wales, Sydney. He researches in all areas of child and family psychology, in particular the development and treatment of anxiety, aggression, and depression in children. He is involved in a number of nationally funded research projects evaluating early intervention programs for children and families experiencing mental health problems. He has published widely on child and family psychology, and is a well-known child and family therapist.

Louisa Degenhardt is a Lecturer at the National Drug and Alcohol Research Centre, University of New South Wales, Sydney. She has recently completed her PhD thesis examining comorbidity between substance use disorders and mental disorders in the general population. She has been involved in a range of research projects examining the epidemiology of substance use disorders and related harms.

Kevin Gournay is Professor of Psychiatric Nursing and Deputy Director of the Health Services Research Section of the Institute of Psychiatry in London. He is also responsible for several national and international UK multidisciplinary training programs. In 1997 he was appointed as a member of the UK Government's Reference Group which is developing a new framework for mental health services.Top of page

Wayne Hall is a Professorial Research Fellow and Director of the Office of Public Policy and Ethics in the Institute of Molecular Bioscience at the University of Queensland, Brisbane. He has recently completed seven years as Executive Director of the National Drug and Alcohol Research Centre where he was involved in the planning and conduct of Australia's first epidemiological survey of mental disorders and substance use disorders, the National Survey of Mental Health and Wellbeing. He is the author of a number of reviews of issues surrounding comorbidity and numerous scientific publications.

Cathy Issakidis is a Senior Research Officer at the World Health Organisation (WHO) Collaborating Centre for Evidence and Health Policy in Mental Health at St Vincent's Hospital in Sydney. Her research areas include mental health service delivery and the epidemiology of mental disorders in Australia. She recently completed her PhD examining the pathways to effective care for anxiety disorders.

David Kavanagh is Associate Professor of Psychology at the University of Queensland, Brisbane. His research includes the treatment of schizophrenia, including schizophrenia comorbid with cannabis use disorders. David's primary current areas of research and practice are in the assessment and management of comorbid substance abuse and mental disorder, and the dissemination of clinical procedures to routine clinical settings (including the evaluation of training impact).

Michael Lynskey currently holds a position as Senior Research Fellow at the Queensland Institute of Medical Research, University of Queensland. He is currently on leave from that position, and is employed as a Visiting Professor in the Department of Psychiatry,Washington University in St Louis, where he is undertaking advanced training in behaviour genetics. He also holds honorary appointments at the University of New South Wales and the Australian National University. His research interests include the epidemiology and aetiology of drug use and drug-related harm.

Leonie Manns is Chair of the New South Wales Disability Council and New South Wales Mental Health Association. She has been a member of a number of Australian national committees including the National Community Advisory Group, the Australian Health Ministers Working Group for Mental Health and the Steering Committee for the National Survey of Mental Health and Wellbeing. Currently she is a member of the National Working Party on Promotion, Prevention and Early Intervention and a Ministerial appointment to the New South Wales Mental Health Implementation Group. She is a well-known and respected consumer advocate.

Kim Mueser is a licensed clinical psychologist and a Professor in the Departments of Psychiatry and Community and Family Medicine at the Dartmouth Medical School in Hanover, New Hampshire. His clinical and research interests include the psychosocial treatment of severe mental illnesses, dual diagnosis, and post-traumatic stress disorder. He has published extensively and given numerous lectures and workshops on psychiatric rehabilitation.

Heather Proudfoot is an honours graduate in Psychology at the University of New South Wales who is currently undertaking a PhD at the National Drug and Alcohol Research Centre. Her research interests are effective treatments and pathways to care for alcohol problems.

Tim Slade is a Senior Research Officer at the WHO Collaborating Centre for Evidence and Health Policy in Mental Health at St Vincent's Hospital in Sydney. His research interests include classification and epidemiology of mental disorders and the use of structured diagnostic interviews in psychiatry. He recently completed his PhD looking at how epidemiological data can be used to inform revisions to psychiatric classification systems.

Maree Teesson is Associate Professor and Deputy Director at the National Drug and Alcohol Research Centre, University of New South Wales, Sydney. Her research interests are in the areas of epidemiology of mental disorders, the effectiveness of treatments and effective systems of service delivery.
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