Occurrence and Treatment

C is the occurrence of two or more illnesses in the same person. The term “psychiatric comorbidity,” as used in this article, refers to the occurrence in the same person of at least one mental disor­ der and one addictive disorder. For exam­ ple, a person suffering from schizophrenia may be addicted to alcohol and perhaps to other drugs as well.1 Psychiatric comorbidity presents problems for clinicians and patients alike. Comorbid disorders are poorly understood and frequently misdiagnosed, and their treatment is problematic. Alcoholics with psychiatric disorders often fall through the cracks in the health care system, failing to receive treatment for one or the other of their disorders (Minkoff 1989; Ries 1993). Nevertheless, prospects for effective treatment are improving with the increas­ ing integration of psychiatric and addic­ tion treatment perspectives. This article explores some problems in recognizing comorbidity and evaluates current treat­ ment models.