When an addiction and a mental health disorder coexist - a condition known as dual disorder - scientific evidence indicates that integrated psychological treatment improves clinical outcomes and reduces the risk of relapse. Now, studies published in the Journal of Clinical Medicine confirm that integrated psychological treatment, in which the same team simultaneously addresses both the substance use disorder and the other mental health disorder, is more effective than treating them separately.
The study, carried out by an international consensus research promoted by the World Association on Dual Disorders and the Spanish Society of Dual Disorders, is signed by researchers from the Faculty of Psychology and the Institute of Neurosciences (UBneuro) at the University of Barcelona, CEU Cardenal Herrera University, the Bellvitge University Hospital and the European University of Madrid.
What is dual disorder?
Dual disorder refers to the coexistence of a substance use disorder - such as alcohol or other drugs - and a mental health disorder, such as depression, anxiety or schizophrenia. In many cases, both disorders interact and influence each other. Sometimes substance use begins as an attempt to relieve pre-existing discomfort; in other situations, it is the substance use that precipitates or exacerbates mental health symptoms. If only one disorder is treated, improvement may be partial and the risk of relapse higher.
In current clinical practice, the concept also includes behavioural addictions, such as gambling disorder, which share clinical and neurobiological mechanisms with substance addictions.
Studies estimate that more than 90% of adults with dual disorder do not receive specific, coordinated treatment for both disorders. "This lack of comprehensive approach can hinder recovery and increase the risk of relapse. The consensus highlights that the separation between services or treatments does not always reflect the clinical reality of these individuals," says Professor Ana Adan, co-author of the studies and member of the Department of Clinical Psychology and Psychobiology at the Faculty of Psychology and UBneuro.
Which interventions work best?
The two articles review the available scientific evidence and conclude that psychological treatment is effective in dual disorder. The interventions with the strongest scientific support are motivational interviewing, cognitive-behavioural therapy, relapse-prevention strategies and multicomponent programmes tailored to each individual.
The articles also analysed specific combinations, such as dual disorders associated with anxiety disorders, post-traumatic stress disorders, neurodevelopmental disorders or personality disorders. In many cases, cognitive-behavioural therapy is the first-line treatment, although the research team notes that research in some areas needs to be strengthened.
"When addiction and mental health disorders are treated separately, the risk of repeated relapses is higher. An integrated approach helps break this cycle of relapse to be reduced and improves treatment adherence," explains researcher Ana Benito, first author of the articles and a member of the Spanish Society of Dual Disorders.
More evidence to move forward
The team also emphasizes that there are still few randomized clinical trials and that many studies have methodological limitations. Therefore, at the consensus conference a research agenda was established to improve the quality of the available evidence. The participation of professionals from the Bellvitge University Hospital in this international consensus reinforces the centre's commitment to evidence-based, integrated, person-centred care.
"Dual disorders require multidisciplinary teams and an integrated approach. Treating the addictive disorder and the mental health disorder separately can limit the effectiveness of treatment. Coordination and personalization of intervention are key. In this regard, the consensus provides a clear scientific framework for moving towards more coordinated, effective and tailored care for each situation," concludes Ana Benito.
Reference articles:
Benito, Ana; Jiménez-Murcia, Susana; Tirado-Muñoz, Judit; Adan, Ana. "WADD-SEPD Consensus on Psychological Treatment of Dual Disorders I: General Recommendations, Most Used Therapies, and Severe Mental Disorders" . Journal of Clinical Medicine, January 2026. DOI:10.3390/jcm15020730.
Benito, Ana; Jiménez-Murcia, Susana; Tirado-Muñoz, Judit; Adan, Ana. "WADD-SEPD Consensus on Psychological Treatment of Dual Disorders II: Neurodevelopmental, Anxiety, Post-Traumatic Stress, Somatic Symptom, Eating, and Personality Disorders and Recommendations for Future Research" . Journal of Clinical Medicine, January 2026. DOI: 10.3390/jcm15031105.
