ADM ADM Co-occurring Disorders & Dual Diagnosis 2 — Questions and Answers
Question 1: Which screening tool is commonly used to identify depression in patients with substance use disorders?
- CAGE questionnaire
- PHQ-9 (Correct answer)
- AUDIT-C
- DAST-10
Correct answer: PHQ-9
The PHQ-9 (Patient Health Questionnaire-9) is a validated, widely used screening tool for depression in patients with substance use disorders.
Question 2: When assessing a dual diagnosis patient, which factor is most important before diagnosing a primary psychiatric disorder?
- Family psychiatric history
- A period of sobriety to clarify substance-free psychiatric status (Correct answer)
- Insurance coverage for mental health treatment
- Number of prior hospitalizations
Correct answer: A period of sobriety to clarify substance-free psychiatric status
A period of sobriety is needed to determine whether psychiatric symptoms are substance-induced or represent an independent primary disorder, as many symptoms resolve with abstinence.
Question 3: Which antidepressant class is generally preferred for treating depression in patients with alcohol use disorder due to its safety profile?
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Benzodiazepines
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are preferred in patients with alcohol use disorder due to their favorable safety profile, lower overdose risk, and fewer dangerous interactions with alcohol.
Question 4: What is the primary clinical concern with using benzodiazepines for chronic anxiety management in patients with non-alcohol substance use disorders?
- They are ineffective for anxiety in this population
- High risk of dependence and cross-addiction (Correct answer)
- They cause immediate seizures in SUD patients
- FDA has banned their use in SUD patients
Correct answer: High risk of dependence and cross-addiction
Benzodiazepines carry a high risk of dependence and cross-addiction in patients with existing substance use disorders, making them generally avoided for chronic anxiety management.
Question 5: Which evidence-based integrated psychotherapy was specifically developed to treat co-occurring PTSD and substance use disorders simultaneously?
- Psychodynamic therapy
- Cognitive Processing Therapy alone
- Seeking Safety (Correct answer)
- Interpersonal Therapy
Correct answer: Seeking Safety
Seeking Safety is an evidence-based integrated therapy specifically designed to address co-occurring PTSD and substance use disorders at the same time.
Question 6: Which mood stabilizer has evidence supporting its use in patients with co-occurring bipolar disorder and alcohol use disorder, potentially reducing both mood symptoms and drinking?
- Lamotrigine
- Valproate (divalproex) (Correct answer)
- Lithium alone
- Gabapentin
Correct answer: Valproate (divalproex)
Valproate (divalproex) is FDA-approved for bipolar disorder and has evidence showing it may reduce both mood symptoms and alcohol consumption in co-occurring AUD.
ADM ADM Co-occurring Disorders & Dual Diagnosis 2
Which screening tool is commonly used to identify depression in patients with substance use disorders?