CARN Managing Co-Occurring Disorders 2

Question 1

A patient with bipolar disorder and alcohol use disorder is stabilized on lithium. Which intervention is most critical regarding alcohol use and lithium therapy?

Accepted Answer

Educate that alcohol can lower lithium levels and trigger manic episodes

Answer

Encourage moderate alcohol use to reduce social anxiety

Answer

Monitor lithium levels only during depressive phases

Answer

Discontinue lithium if the patient relapses on alcohol

Question 2

Which screening tool is specifically designed to identify co-occurring mental health disorders in patients presenting with substance use disorders?

Accepted Answer

MINI International Neuropsychiatric Interview (MINI)

Answer

AUDIT-C

Answer

DAST-10

Answer

PHQ-2

Question 3

A patient in early recovery from opioid use disorder begins reporting panic attacks. The CARN should first:

Accepted Answer

Conduct a thorough psychiatric assessment to differentiate withdrawal from panic disorder

Answer

Assume symptoms are opioid withdrawal and monitor without intervention

Answer

Prescribe benzodiazepines to address the panic disorder

Answer

Refer immediately to psychiatry and withhold all medications

Question 4

The concept of 'parallel treatment' for co-occurring disorders means:

Accepted Answer

Treating addiction and mental health simultaneously in separate programs without coordination

Answer

Using two medications simultaneously for the same diagnosis

Answer

Addressing both disorders in an integrated manner within one treatment episode

Answer

Alternating treatment focus between addiction and mental illness each session

Question 5

A patient with schizophrenia and cannabis use disorder states they use cannabis to 'calm the voices.' This pattern is best described as:

Accepted Answer

Self-medication to manage psychotic symptoms

Answer

Recreational drug use unrelated to mental illness

Answer

A sign of medication non-adherence only

Answer

Malingering to obtain psychiatric care

Question 6

Which factor most significantly complicates the diagnosis of depression in a patient actively using cocaine?

Accepted Answer

Cocaine withdrawal mimics depressive symptoms, making diagnosis unreliable during active use

Answer

Cocaine has no effect on mood or neurochemistry

Answer

Depression is always secondary to cocaine use and resolves with abstinence

Answer

Patients with cocaine use disorder cannot experience true depression

Question 7

Motivational Interviewing (MI) is considered an evidence-based approach for co-occurring disorders primarily because it:

Accepted Answer

Addresses ambivalence about change without triggering defensiveness

Answer

Confronts denial aggressively to force behavior change

Answer

Focuses exclusively on substance use without addressing mental health

Answer

Requires patients to commit to abstinence before beginning therapy