Features of behavior regulation in persons with severe mental disorders comorbid with addiction to psychoactive substances

Features of behavior regulation in persons with severe mental disorders comorbid with addiction to psychoactive substances

 

Authors

 

E.V. Leurda

FSBI “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

O.A. Makushkina

FSBI “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

A.V. Frolova

FSBI “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

 

https://doi.org/10.26617/1810-3111-2024-2(123)-49-64

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2024; 2 (123):  49-64.

 

Abstract

Background.The comorbidity of mental disorders with addiction to psychoactive substances (PAS) and its high prevalence in offenders determined the priority for further scientific development of the concept of dual diagnosis in psychiatry, as well as the characteristics of self-control and dysregulation of behavior in this category of patients. Their study was extremely important for predicting the risk of public danger and determining the tactics of preventive interventions. Objective of the review was to systematize data on the clinical, cognitive and emotional characteristics of patients suffering from mental disorders and comorbid addiction to psychoactive substances, which influenced the regulation of behavior. Materials and Methods. A search of scientific literature was conducted using scientometric databases (PubMed, Embase, Clinical Trials, Google Scholar databases, eLibrary). Publications were selected that covered disturbances of self-regulation domains (cognitive and metacognitive functions, emotional regulation) and features of the clinical picture in people with mental disorders and comorbid addiction to psychoactive substances. Results. According to the results of the studies discussed, comorbidity had a significant impact on the formation of dysregulation of mental functions in persons with severe mental disorders. Patients with so-called dual diagnosis had a higher prevalence and severity of behavioral disorders, such as impulsivity or decreased control, as well as significant cognitive and metacognitive deficits, represented by dysregulation of executive functioning and impaired meta-cognition. The specifics of their emotional dysfunctions needed further study. Scientific papers also indicated the importance of training the emotional regulation in mental disorders comorbid with substance abuse. Researchers noted the influence of emotional reactions that were disproportionate to the stimulus that caused them, and difficulties in managing emotions on the clinical picture in the form of its complication, including as a result of the reciprocal influence of cognitive impairment and behavioral disorders. Conclusion. The data obtained indicated the need for further research to better understand the mechanisms of interaction between clinical features and self-regulation domains, and their impact on behavior dysregulation in this category of patients. Identification of specific mechanisms of dysregulation in patients with comorbid addiction to psychoactive substances was a significant incentive for the development of diagnostic and treatment methods aimed at improving the quality of life and reducing the risk of social danger.

 

Keywords: mental disorders, comorbidity, substance dependence, cognitive functions, emotional regulation, behavioral disorders, dysregulation.

 

Article (pdf)

 

Contacts

 

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Materials  

For citation: Leurda E.V., Makushkina O.A., Frolova A.V. Features of behavior regulation in persons with severe mental disorders comorbid with addiction to psychoactive substances. Siberian Herald of Psychiatry and Addiction Psychiatry.2024; 2 (123): 49-64. https://doi.org/10.26617/1810-3111-2024-2(123)-49-64

 

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