Recovery From Comorbidity

Comorbidity among mood, anxiety, and alcohol disorders is commonand burdensome, affecting individuals, families, and public health. A systematic andintegrative review of the literature across disciplines and research methodologies wasperformed. Supradisciplinary approaches were applied to the review and the ensuingcritical appraisal. Definitions, measurement, and estimation are controversial andinconstant. Recovery from comorbidity cannot be easily extricated from a socioculturalmilieu. Methodological challenges in quantitative and qualitative research and acrossdisciplines are many and are discussed. The evidence supporting current treatments issparse and short-term, and modalities operating in isolation typically fail. Peopleeasily fall into the cracks between mental health and addiction services. Cliniciansfeel untrained and consumers bear the brunt of this: Judgmental and moralisticinteractions persist and comorbidity is unrecognized in high-risk populations. Competinghistorical paradigms of mental illness and addiction present a barrier to progress andreductionism is an impediment to care and an obstacle to the integration andinterpretation of research. What matters to consumers is challenging to quantify butworth considering: Finding employment, safe housing, and meaning are crucial torecovery. Complex social networks and peer support in recovery are important but poorlyunderstood. The focus on modalities of limited evidence or generalizability persists inliterature and practice. We need to consider different combinations of comorbidity,transitions as opposed to dichotomies of use or illness, and explore the long-term viewand emic perspectives