People with psychosis often develop an addiction disorder: almost one in two patients with schizophrenia are affected once during their lifetime. Patients with a dual diagnosis mostly have a poorer prognosis, and their disorder often becomes chronic. Euphrosyne Gouzoulis-Mayfrank and colleagues investigated in a randomized controlled study in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2015; 112: 683-91) whether disorder-specific treatment can improve patients' motivation to remain abstinent and reduce their substance misuse. They applied an evaluated therapeutic program that would be easy to implement in standard care.
100 dual diagnosis patients participated in the study, who were voluntarily admitted to inpatient treatment for their disorders. While everyone received standard treatment--such as individual therapeutic sessions, therapy for their psychosis, and cognitive training--some of the patients were allocated to disorder-specific group treatments that focused on their motivation to remain abstinent as well as psychoeducation. Subsequently they were offered additional cognitive behavioural therapy on an outpatient basis. The researchers documented the course of treatment for one year and found that patients receiving disorder-specific treatment had a slightly stronger motivation for abstinence and their substance consumption was slightly lower compared with patients receiving conventional treatment. The authors stressed, however, that such treatment will yield only moderate improvements in dual diagnosis patients. Because of the limited number of study participants, they recommend verifying the results in more elaborate studies and identifying subgroups that may respond better to treatment.