Abstract
Patients with ?double diagnoses?, comorbidity of psychoses and substance use disorders, are met with insecurity in the treatment systems. Often they are shuttled back and forth between the mental health and substance abuse treatment systems. One of the reasons is a lack of unifying theoretical basis. At present, progress in neurobiologic research has increased our understanding of the etiology but may increase pessimism and confusion in therapy. The paper presents and discusses rational-choice theory as a unifying approach. Irrationality is central to the concept of psychoses and insufficient influence of rationality to the problems of substance abuse. Limitations in rationality thus might be seen as a unifying concept, and the logics of rational choice as fruitful in the encounter with the double-diagnosis patient.
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