Addiction Medicine Certification Addiction Medicine Co-occurring Disorders & Dual Diagnosis 2 — Questions and Answers
Question 1: In a patient with schizophrenia and cannabis use disorder, which antipsychotic has the most evidence for reducing cannabis use?
- Haloperidol
- Clozapine (Correct answer)
- Chlorpromazine
- Perphenazine
Correct answer: Clozapine
Clozapine has the strongest evidence among antipsychotics for reducing substance use, including cannabis, in patients with schizophrenia.
Question 2: When differentiating substance-induced psychosis from primary psychosis, which timeframe is most commonly used for observation after abstinence?
- 24 hours
- 48 hours
- 4 weeks (Correct answer)
- 6 months
Correct answer: 4 weeks
DSM-5 guidelines suggest that if psychotic symptoms persist beyond 4 weeks of abstinence, a primary psychotic disorder is more likely.
Question 3: Which mood stabilizer is considered first-line for bipolar disorder co-occurring with alcohol use disorder?
- Lithium
- Valproate (divalproex) (Correct answer)
- Lamotrigine
- Carbamazepine
Correct answer: Valproate (divalproex)
Valproate (divalproex) has demonstrated efficacy for both bipolar disorder and reduction of alcohol use in patients with co-occurring conditions.
Question 4: Which anxiety disorder has the highest rate of co-occurrence with substance use disorders?
- Generalized anxiety disorder
- Social anxiety disorder (Correct answer)
- Panic disorder
- Specific phobia
Correct answer: Social anxiety disorder
Social anxiety disorder (social phobia) has the highest prevalence among anxiety disorders co-occurring with substance use disorders, as patients often use alcohol or other substances to manage social situations.
Question 5: A clinician suspects a patient's depression is substance-induced rather than primary. Which finding best supports this conclusion?
- Family history of major depressive disorder
- Depressive symptoms that precede substance use by several years
- Depressive symptoms that resolve within weeks of abstinence (Correct answer)
- Depression that does not respond to antidepressant therapy
Correct answer: Depressive symptoms that resolve within weeks of abstinence
Resolution of depressive symptoms within weeks of achieving abstinence is the hallmark indicator that depression was substance-induced rather than a primary mood disorder.
Question 6: Which integrated treatment model delivers mental health and substance use services within the same program and clinical team?
- Sequential treatment model
- Parallel treatment model
- Integrated dual disorder treatment (IDDT) (Correct answer)
- Stepped care model
Correct answer: Integrated dual disorder treatment (IDDT)
Integrated Dual Disorder Treatment (IDDT) is the evidence-based model where mental health and substance use services are provided by the same team in the same setting.
Addiction Medicine Certification Addiction Medicine Co-occurring Disorders & Dual Diagnosis 2
In a patient with schizophrenia and cannabis use disorder, which antipsychotic has the most evidence for reducing cannabis use?