Ashton E Clark, Shelby R Goodwin, Russell M Marks, Annabelle M Belcher, Emily Heinlein, Melanie E Bennett, Daniel J O Roche
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引用次数: 0
Abstract
Objective: Panic disorder is a debilitating psychiatric disorder that often co-occurs with substance use disorders. Given the current opioid epidemic, the high reported rates of comorbid panic disorder and opioid use disorder are particularly concerning. In this narrative review, we describe the literature on panic disorder and opioid use disorder co-occurrence.
Methods: 86 studies, 26 reviews, 2 commentaries, and 5 guidelines pertaining to opioid use disorder, panic disorder, and their comorbidity were identified using all EBSCO databases, PubMed, and Google Scholar.
Results: First, we review epidemiological literature on the prevalence of the comorbid condition above and beyond each disorder on its own. Additionally, we discuss the challenges that complicate the differential diagnosis of panic disorder and opioid use disorder and contribute to difficulties establishing rates of comorbidity. Second, we review three theoretical models that have been proposed to explain high rates of co-occurring panic disorder and opioid use disorder: the precipitation hypothesis, the self-medication hypothesis, and the shared vulnerability hypothesis. Third, we outline how co-occurring panic and opioid use disorder may impact treatment for each condition.
Conclusion: Based on findings in the field, we provide recommendations for future research as well as treatment considerations for co-occurring panic and opioid use disorders.
期刊介绍:
Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.