Concurrent (Dual) Disorder Management Guidelines: Systematic Review Update.

Area of Science:

• Clinical Practice Guidelines
• Mental Health
• Substance Use Disorders

Background:

• A 2020 systematic review assessed concurrent disorder management guidelines (2000-2020).
• Increasing dual disorder prevalence, especially in younger populations, necessitates efficient management strategies.
• New guidelines have emerged since 2020 due to advancements in substance use disorder management.

Purpose of the Study:

• To identify and appraise new concurrent disorder management guidelines published between 2020 and 2025.
• To strategize concurrent disorder management for improved patient outcomes.
• To inform future research directions in the field.

Main Methods:

• Systematic review update registered on PROSPERO.
• Literature searches conducted in electronic databases and gray literature.
• Inclusion of English-language clinical management guidelines for adult concurrent disorders (2020-2025); exclusion of non-guideline sources, non-physician targets, and non-English content.

Main Results:

• Eight new guidelines were identified and appraised using AGREE II (Appraisal of Guidelines for Research and Evaluation).
• A consistent gap in evidence-based management recommendations was observed.
• New guidelines exhibited similar quality to 2020 findings, with low average domain scores, particularly in applicability and editorial independence.

Conclusions:

• The appraised guidelines support dual or combined treatment but have methodological limitations.
• Recommendations lack consideration for treatment complexity, staging, resource implications, and patient involvement.
• Development of high-quality, evidence-based guidelines addressing these gaps is recommended due to an underdeveloped evidence base.