Abstract
Over 50% of people diagnosed with a severe mental illness, such as schizophrenia or bipolar disorder, will meet criteria for a substance use disorder in their lifetime. This dual disorder often starts during youth and leads to significant societal costs, including lower employability rates, more hospitalizations, and higher risk of homelessness and of suicide attempts when compared to those with a serious mental illness without substance misuse. Moreover, many individuals presenting with comorbid disorders also present with other psychological difficulties as well, such as personality disorders or anxiety and depression, also known as complex comorbid disorders. Transdiagnostic treatments that focus on core difficulties found in people with complex dual disorders, such as emotional regulation, are direly needed. Emotional regulation skills can help reduce distress related to psychotic symptoms and maintain abstinence in substance use disorders. New technologies in the field of communications have developed considerably over the past decade and have the potential to improve access to such treatments, a major problem in many health care settings. As such, this paper aims at: presenting core difficulties present in many individuals with dual disorders, reviewing the scientific literature pertaining to the use of mobile applications in mental health and addictions, and presenting the development and potential of a new application for emotional regulation for people with dual disorders.
Highlights
Severe mental illness (SMI) typically includes psychotic episodes and can be characterized by the presence of positive symptoms, and negative or depressive symptoms or symptoms of disorganized thought and behavior [1]
Among the consequences related to dual disorders (i.e., SMI + substance use disorder), we find a higher rate of violent crimes [12, 13], more hospitalization, poorer compliance to treatment [13, 14], more relapses [14], a higher rate of sexually transmitted and blood-borne infections (STBBIs, including HIV) [15], a higher rate of homelessness [16, 17], more psychiatric symptoms [14, 18], poorer treatment outcomes [19], and a greater suicide rate [20] than people with a noncomorbid SMI
An epidemiological study reports that 78% of individuals with borderline personality disorder met the criteria for substance use disorder at least once in their lifetime [21]
Summary
Severe mental illness (SMI) typically includes psychotic episodes and can be characterized by the presence of positive (e.g., delusions, hallucinations) symptoms, and negative or depressive symptoms (e.g., flat affects, avolition) or symptoms of disorganized thought and behavior [1]. Mobile Intervention for Individuals With SMI them will maintain a cognitive functioning within the norm) [2]. SMIs are marked by social functioning difficulties ( difficulties starting or maintaining a conversation, attaining a goal, or meeting basic needs requiring a simple conversation/interaction with others). These difficulties will lead to social integration problems that can occur throughout different stages of the disorder [2]. A hypothesis that might explain this phenomenon is that individuals with SMI have a deficit in the reward circuit (i.e., neural network involving the ventral tegmental area and the nucleus accumbens) [9]. Among the consequences related to dual disorders (i.e., SMI + substance use disorder), we find a higher rate of violent crimes [12, 13], more hospitalization, poorer compliance to treatment [13, 14], more relapses [14], a higher rate of sexually transmitted and blood-borne infections (STBBIs, including HIV) [15], a higher rate of homelessness [16, 17], more psychiatric symptoms [14, 18], poorer treatment outcomes [19], and a greater suicide rate [20] than people with a noncomorbid SMI
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