Substance misuse and psychiatric comorbidity: towards improved service provision

Much progress has been made in terms of improved diagnostic techniques for individual disorders, i.e, substance misuse or psychiatric disorders. Some progress has been made for the application of these assessment procedures f or combined disorders, thereby providing prevalence rates which vary widely due to the methodological problems. Far less progress has been made in the understanding of the natural history and outcome of combined disorders. Re latively little research has been carried out on treatment strategies for p eople with dual disorders (including polysubstance abuse and dependence). A s a consequence, appropriate multidisciplinary and multispecialty service d evelopments, training and research have not been a focus. Awareness of the scale and nature of the problem is important for commissioners and provider s so that resources are targeted appropriately.