[Addiction psychiatry in specialized care--towards more precise differential diagnosis]

A mental disorder and a substance abuse problem are often present simultaneously. Possible underlying substance abuse is surveyed in examining psychic symptoms. Screening of the substance abuse problem facilitates revealing the presence of previously unrecognized substance abuse problems. Screening of alcohol abuse with the AUDIT questionnaire is necessary for all patients in psychiatric specialized care. The DAST-20 questionnaire is utilized in the screening of drug abuse. The DSM-IV diagnosis system and the PRISM interview define more closely the differential diagnosis associated with dual diagnoses. Treatment of a substance abuse problem related to severe mental disorders should be conducted in an integrated manner by the same treatment unit.