Alcoholism - Treatment for Alcoholism

Treating People Who Have Both Alcoholism and Mental Illness

Treatment for patients with both alcoholism and mental illness is particularly difficult. The greater the psychiatric distress a person is experiencing, the more he or she is tempted to drink, particularly in negative situations.

There has been some concern that self-help programs, such as Alcoholics Anonymous (AA), are effective for patients with dual diagnoses of mental illness and alcoholism, because the focus of the organization is on addiction, not psychiatric problems. Studies, however, have reported that they are also effective in many of these patients. (AA may not be as helpful for people with schizophrenia and schizoaffective disorder.) In one interesting study, individuals with a dual diagnosis achieved better abstinence rates after being treated only for alcoholism compared to patients treated for the mental disorder as well. (Cognitive-behavioral therapy was used for both groups.)

Newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are proving to be very useful complements to AA or counseling sessions. Anti-anxiety medications are also available for people with anxiety.

People with alcoholism and more severe problems such as schizophrenia or severe bipolar disorder probably need more intense help. One 2002 study also suggested that women and men with dual diagnoses may need different treatment approaches. Women were more bothered by their psychiatric problems and with social relationships than men were and were more likely to have a history of abuse. Women also had fewer episodes of criminal activity.

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