Abstract Objective: Addiction co-occurs with distinct pathological personality traits, other psychiatric disorders or symptoms and cognitive impairment, which are known as dual disorders or co-occurring disorders. This symptomatic high concurrency suggests that both conditions are in some ways causally linked. Research is ongoing to identify distinctive neurobehavioral mechanisms and endophenotypes that predispose individuals to compulsive drug use and other mental disorders. Research is also providing new revelations about the diverse effects of substances on individuals, including differences according to sex. Today we know that the same substance may give rise to different behavioral, affective, cognitive, and sensory effects across different individuals. Methods: This state-of the art review tends to address the concept of precision psychiatry and dual disorders. The PubMed database was searched for the last 15 years to identify those articles that reported neurobiological perspectives on dual disorders, addiction and other mental disorders, precision medicine, and precision psychiatry. Results: There has been considerable progress made in recent years in relation to the study of addiction and dual disorders. The concept of dual disorders attempts to capture not only the persistence of substance use and substance seeking but also the evident vulnerability of specific subpopulations to switch from controlled to compulsive drug use. Precision medicine is focused on identifying this individual vulnerability to illness as much as the individual response to treatment. Psychiatry is fully committed to this goal. Regarding addiction, essential precision medicine advances will be possible if concerted efforts are made in the discovery of biological variations and environmental factors that contribute to individual vulnerability to addictive disorders and dual disorders, together with the identification of moderators of treatment response. Conclusions: Here we survey the discoveries, future research directions, and translational relevance of the concept of precision psychiatry for dual disorders. The review may offer new perspectives on this issue and highlight a new way to see and to think about dual disorders.

中文翻译：

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精准精神病学和双重疾病

摘要 目的：成瘾与不同的病理性人格特征、其他精神障碍或症状以及认知障碍同时发生，被称为双重障碍或共病障碍。这种有症状的高并发表明这两种情况在某些方面存在因果关系。正在进行研究以确定使个体易患强迫性药物使用和其他精神障碍的独特神经行为机制和内表型。研究还提供了关于物质对个体的不同影响的新启示，包括性别差异。今天我们知道，同一种物质可能会对不同的人产生不同的行为、情感、认知和感官影响。方法：这种最先进的评论倾向于解决精确精神病学和双重疾病的概念。在过去的 15 年中，我们对 PubMed 数据库进行了搜索，以确定那些报道了关于双重障碍、成瘾和其他精神障碍、精准医学和精准精神病学的神经生物学观点的文章。结果：近年来，在成瘾和双重障碍的研究方面取得了相当大的进展。双重障碍的概念不仅试图捕捉物质使用和物质寻求的持续存在，而且还试图捕捉特定亚群从受控药物使用转向强迫性药物使用的明显脆弱性。精准医学的重点是识别这种个体对疾病的脆弱性，以及个体对治疗的反应。精神病学完全致力于实现这一目标。关于成瘾，如果齐心协力发现导致个体易患成瘾性疾病和双重疾病的生物变异和环境因素，并确定治疗反应的调节剂，那么基本的精准医学将有可能取得进展。结论：在这里，我们调查了精确精神病学概念对双重障碍的发现、未来研究方向和转化相关性。该综述可能会就此问题提供新的视角，并突出一种看待和思考双重障碍的新方法。如果共同努力发现导致个体易患成瘾性疾病和双重疾病的生物变异和环境因素，并确定治疗反应的调节剂，则基本的精准医学进步将成为可能。结论：在这里，我们调查了精确精神病学概念对双重障碍的发现、未来研究方向和转化相关性。该综述可能会就此问题提供新的视角，并突出一种看待和思考双重障碍的新方法。如果共同努力发现导致个体易患成瘾性疾病和双重疾病的生物变异和环境因素，并确定治疗反应的调节剂，则基本的精准医学进步将成为可能。结论：在这里，我们调查了精确精神病学概念对双重障碍的发现、未来研究方向和转化相关性。该综述可能会就此问题提供新的视角，并突出一种看待和思考双重障碍的新方法。