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Dual disorders or dual diagnosis?

Nestor Szerman1,2, Lars Lien3, Ruben Baler4

  • 1World Association on Dual Disorders. World Psychiatric Association, Section on Dual Disorders, Madrid, Spain.

Irish Journal of Psychological Medicine
|December 12, 2025
PubMed
Summary

Dual disorders, the co-occurrence of addiction and mental health conditions, require integrated care. Adopting "dual disorders" as a unified term can improve treatment and reduce stigma for better patient outcomes.

Keywords:
Addictionbrain disease model of addiction (BDMA)comorbiditydual disorders (DD)integrated caremental healthprecision psychiatrystigmasubstance use disorders (SUDs)wrong-door syndrome

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Addiction Medicine

Background:

  • Dual disorders (DD) involve the co-occurrence of substance use disorders and other mental health conditions.
  • These conditions often share underlying brain mechanisms and interact, complicating diagnosis and treatment.
  • Current diagnostic systems often separate these conditions, leading to fragmented care and patient stigma.

Purpose of the Study:

  • To advocate for the adoption of "dual disorders" as a unified diagnostic and treatment term.
  • To highlight the need for integrated care models that address the complexities of co-occurring conditions.
  • To reduce stigma associated with addiction and mental health disorders by promoting a cohesive understanding.

Main Methods:

  • Review of scientific literature on shared neurobiological pathways in addiction and mental illness.
  • Analysis of current diagnostic and treatment paradigms for co-occurring disorders.
  • Examination of recommendations from the World Association on Dual Disorders (WADD).

Main Results:

  • Evidence supports shared brain mechanisms underlying dual disorders.
  • Separate diagnostic approaches lead to fragmented treatment and negative patient outcomes.
  • A unified term and integrated care approach are recommended by WADD.

Conclusions:

  • Adopting "dual disorders" as a unified term can enhance clarity and improve care integration.
  • Integrated treatment strategies are crucial for effectively managing co-occurring addiction and mental health conditions.
  • Unified terminology and care approaches can reduce stigma and improve patient outcomes.