Patients with co-occurring disorders (COD, also known as “dual diagnosis”) are often regarded as among the most challenging patients to treat. You need to track two conditions that interact in unpredictable ways, with patients who may not be inclined to follow your recommendations. It’s no surprise that such patients typically have poorer outcomes than those with either disorder in isolation. And these patients are far from rare.

Despite an increased awareness of co-occurring disorders, there remains a fair amount of confusion about how to treat a mental health issue and a substance abuse issue at the same time without causing more harm. To further complicate the issue, when patients first walk in you often don’t know whether they are dealing with two conditions concurrently. Charles Atkins’ book, Co-Occurring Disorders: Integrated Assessment and Treatment of Substance Use and Mental Disorders, addresses these problems. We turned to him for some practical guidance.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit.

Dr. Gardiner recommends ConsumerLab.com to patients to “try to stop them from hurting themselves with mislabeled products or wasting their money” and to help determine whether a supplement might interfere with a medication he is prescribing.

How can you help increase the odds that Robert, or any of your patients, will succeed in recovery? Here are eight key strategies that support long-term recovery.

Addiction treatment often begins with high hopes and apparent success, but it’s important to remember that addiction is a disease with a relapse rate of 40%–60%. Be realistic: Expect that patients will go through cycles of relapse and recovery. Learn the warning signs for relapse, the measures you can take to prevent it, and what to do after it has occurred.

For many people, the word “recovery” means being in AA or another 12-step program where the goal is to stay abstinent. It’s a culture of mutual support where people help and assist each other toward the goal of sobriety.

As director of psychiatry at Hebrew SeniorLife for 18 years, Dr. Metzger has witnessed a number of changes in how we manage agitation and other elements of BPSD. In this article, he outlines current thinking about such symptoms, as well as the latest techniques—both pharmacologic and non-pharmacologic—for managing them.

Insomnia is so ubiquitous and misunderstood with respect to its health consequences and “treatability.” At the core of this is the widespread misconception that insomnia is primarily a symptom of other things. Insomnia is also identified in DSM-5 as an independent disorder (780.52) which, when occurring with other DSM-5 disorders, is considered a comorbid disorder rather than a symptom.

Tourette’s disorder (TD), also known as Tourette syndrome, is a fascinating yet complex neurodevelopmental disorder that can be challenging to treat. Dr. Georges Gilles de la Tourette, a French neurologist who described the first nine cases in 1885, had it right when he described the “peculiar” symptoms as a syndrome, later reporting that “fears, phobias, and arithmomania” were part of the picture.