This issue of the Journal of Dual Diagnosis includes eight articles delineating many aspects of the fascinating interplay of the co-occurrence of substance use and psychiatric disorders and the many approaches being taken to understand and treat such dual disorder conditions. Karapareddy et al., in a scholarly review, set out to determine the difference in existing treatment models for co-occurring mental health and substance use disorders, with an eye toward policy recommendations. They conclude that while the literature is limited, and conclusions must be tentative, integrated models of care seem most able to achieve both reductions in substance use and improvement in mental health. Bhalla et al. report on patients served within the Veterans Administration who have both posttraumatic stress disorder (PTSD) and substance use disorder and indicate that, prior to treatment, the use of a greater number of substances is associated with more severe PTSD symptoms (as well as more days of substance use). And at follow-up after treatment, the association, although somewhat attenuated, still was detected. Jane et al. address the question of whether the amino acid glycine could be helpful for patients with schizophrenia and alcohol dependence. The study is based on other data indicating the possible benefit of glycine, with its action on the NMDA receptor, on both symptoms of schizophrenia and substance use independently. The results do not show a statistical benefit of the use of glycine, although there was a suggestion of a decrease in symptoms of schizophrenia that might have become significant with a larger sample. Other studies appear warranted. Hass et al. report on posttraumatic stress symptoms (PTSS), alcohol misuse, and anxiety sensitivity in a group of Black college students. They conclude that anxiety sensitivity provides an indirect effect on alcohol use through PTSS—which are associated with higher levels of alcohol use. In another study of college students, Eddinger et al. assess the effect of a history of losses and alcohol use. They report an association of a history of sudden, violent loss with alcohol use. D’Souza et al. note that low resting frequency–heart rate variability is associated with drug and alcohol symptom severity in those with PTSD and substance use disorder. Potvin et al. describe a neuroimaging study of connectivity in patients with schizophrenia who were tobacco smokers as compared to smokers without schizophrenia. They report that those with schizophrenia demonstrated an increased connectivity between the nucleus accumbens and areas of the default mode network. Last, in a pilot study of the use of dialectical behavior therapy (DBT) with skills training for smoking cessation and opioid relapse prevention during methadone treatment, Cooperman et al. note that such a treatment approach is feasible in this population. They call for a randomized trial to test whether DBT skills training can be a helpful intervention.

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本期双重诊断杂志包括八篇文章，描述了物质使用和精神疾病同时发生的迷人相互作用的许多方面，以及为理解和治疗这种双重疾病而采取的许多方法。Karapareddy 等人在一篇学术评论中着手确定现有治疗模式对同时发生的精神健康和物质使用障碍的差异，并着眼于政策建议。他们得出的结论是，虽然文献有限，结论必须是初步的，但综合护理模式似乎最能同时实现减少物质使用和改善心理健康。巴拉等人。报告在退伍军人管理局服务的同时患有创伤后应激障碍 (PTSD) 和物质使用障碍的患者，并指出，在治疗之前，使用更多物质与更严重的 PTSD 症状（以及更多天数）相关物质使用）。在治疗后的随访中，这种关联虽然有所减弱，但仍被检测到。简等人。解决氨基酸甘氨酸是否有助于精神分裂症和酒精依赖患者的问题。该研究基于其他数据，表明甘氨酸对 NMDA 受体的作用可能对精神分裂症的症状和物质使用产生独立的益处。结果没有显示使用甘氨酸的统计益处，尽管有迹象表明精神分裂症的症状可能会随着样本量的增加而显着减少。其他研究似乎是有道理的。哈斯等人。关于一组黑人大学生的创伤后应激症状 (PTSS)、酒精滥用和焦虑敏感性的报告。他们得出结论，焦虑敏感性通过 PTSS 对酒精使用产生间接影响——这与更高水平的酒精使用有关。在另一项对大学生的研究中，Eddinger 等人。评估损失史和饮酒史的影响。他们报告了与饮酒有关的突然、暴力丧失的历史。德索萨等人。请注意，在患有 PTSD 和物质使用障碍的患者中，低静息频率 - 心率变异性与药物和酒精症状的严重程度相关。波特温等人。描述了一项神经影像学研究，将吸烟的精神分裂症患者与没有精神分裂症的吸烟者进行比较。他们报告说，精神分裂症患者表现出伏隔核和默认模式网络区域之间的连接性增加。最后，在一项关于辩证行为疗法 (DBT) 与美沙酮治疗期间戒烟和预防阿片类药物复发的技能培训的试点研究中，Cooperman 等人。请注意，这种治疗方法在该人群中是可行的。他们呼吁进行随机试验来测试 DBT 技能培训是否可以成为一种有益的干预措施。他们报告说，精神分裂症患者表现出伏隔核和默认模式网络区域之间的连接性增加。最后，在一项关于辩证行为疗法 (DBT) 与美沙酮治疗期间戒烟和预防阿片类药物复发的技能培训的试点研究中，Cooperman 等人。请注意，这种治疗方法在该人群中是可行的。他们呼吁进行随机试验来测试 DBT 技能培训是否可以成为一种有益的干预措施。他们报告说，精神分裂症患者表现出伏隔核和默认模式网络区域之间的连接性增加。最后，在一项关于辩证行为疗法 (DBT) 与美沙酮治疗期间戒烟和预防阿片类药物复发的技能培训的试点研究中，Cooperman 等人。请注意，这种治疗方法在该人群中是可行的。他们呼吁进行随机试验来测试 DBT 技能培训是否可以成为一种有益的干预措施。