A review of the literature on co-occurring severe mental illness and substance misuse : epidemiology, terminology, etiology, treatment, and recovery

The complexity of information produced since the 1980's on co-occurring severe mental illness and substance misuse makes it difficult for social workers to grasp the current state of the question. This is a new field of study, and much of the information is incomplete or contradictory. This review examines epidemiological studies carried out in North America. We identify the varied semantic and philosophical approaches to the question of dual diagnoses, and provide an overview of etiological theories, as well as of the theory and practice of treatment for these disorders. Emergent concepts of recovery are also discussed.Major findings. epidemiological data vary, but all point to a widespread problem. The diversity of meaning and of etiological theories appears to be linked to the heterogeneity of this population. An integrated treatment strategy is the current modality of choice, despite outcomes that are only mildly encouraging; finally, there is consensus among consumers that recovery from a disease is possible even in the absence of a complete cure.Research limitations and knowledge gaps are to be expected in a new field of study. Additional research is necessary to determine the extent and causes of these comorbidities. Social workers must become knowledgeable in this field and remain abreast of new developments in order to engage in evidenced-based practice. Greater education about comorbidities is necessary, as is an overarching policy response from all levels of government. The principal contribution of this master's thesis to the discipline of social work is to provide a general synthesis of knowledge in a domain that is highly medicalized in the literature