การพยาบาลเชิงบูรณาการสำหรับผู้ป่วยโรคร่วมจิตเวชและการใช้สารเสพติด

Puthawan Choocherd; Suleemas Angsukiattitavorn

Authors

Puthawan Choocherd Faculty of Nursing, Saint Louis College
Suleemas Angsukiattitavorn Independent Scholar

Keywords:

co-occurring disorders (COD), integrated nursing care, evidence-based practice, multidisciplinary collaboration, case management

Abstract

Introduction: Patients with co-occurring psychiatric and substance use disorders (COD) are a complex and vulnerable group with multidimensional needs. Integrated nursing care addresses these challenges by combining systematic psychiatric care with substance use treatment. This study was conducted as an integrative literature review. Research articles published between 2015 and 2025
were retrieved from PubMed, Scopus, ScienceDirect, and ThaiJo, and subsequently synthesized using thematic analysis.

Objectives: To review the health service system and nursing standards, and present integrated nursing approaches for patients with COD in Thailand.

Key issues: Integrated nursing care for patients with COD comprises medication management and psychosocial therapies, such as Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT), along with case and risk management, including safety measures. These approaches emphasize multidisciplinary collaboration and community-based support systems to ensure continuity of care and sustain treatment effectiveness.

Conclusions: Care for patients with COD requires nursing knowledge, competence, and clinical leadership to integrate assessment, planning, and individualized care in collaboration with the multidisciplinary team.

Implications: To provide systematically integrated care for patients with COD, nurses should enhance their competence and clinical leadership. The implementation of evidence-based guidelines and interprofessional collaboration ensures continuity of care and effectively promote long-term recovery outcomes.

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References

SAMHSA. Substance use disorder treatment for people with co-occurring disorders [Internet]. 2020. [cited 2025 Oct 6]. Available from: https://library.samhsa.gov/sites/default/files/pep20-06-04-006.pdf

Carvalho JD, Garner D. Understanding dual diagnosis: substance abuse and mental illness. Open Access Journal of Addiction and Psychology 2019;2(4):1-9. Available from: https://doi.org/10.33552/OAJAP.2019.02.000541

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th Edition, Text Revision (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022.

National Institute on Drug Abuse (US). Common comorbidities with substance use disorders research report. Bethesda (MD): National Institutes on Drug Abuse; 2020 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK571451

European Monitoring Centre for Drugs and Drug Addiction. Comorbidity of substance use and mental health disorders in Europe (Perspectives on drugs) [Internet]. Lisbon: EMCDDA; 2016 [cited 2025 Jan 3]. Available from: https://www.euda.europa.eu/publications/pods/comorbidity-substance-use-mental-health_en

Poznyak V. World Health Organization guidelines for the treatment of substance use disorders and comorbid conditions. Revista Internacional de Investigación en Adicciones 2018;4(1):1-3.

Kittiratniphaiboon P, Tantarangsee N, Chutha W, Tanaree A, Kwansanit P, Atsanangkornchai S. et al. Prevalence of psychiatric disorders and mental health problems: The National Mental Health Survey of Thai people, 2013. Nonthaburi: Beyond Publishing Co., Ltd.; 2016. (in Thai)

Soonue P, Prapakornsakul P, Pimon P, Phuttharod P. Prevalence of substance used psychiatric outpatient department, Trang Hospital. The Journal of Psychiatric Nursing and Mental Health 2022;36(3):71-80. (in Thai)

Vos T, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet 2020;396(10258):1204-22.

Baingana F, al'Absi M, Becker AE, Pringle B. Global research challenges and opportunities for mental health and substance-use disorders. Nature 2015;527(7578):S172-7.

Kingston REF, Marel C, Mills KL. A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug and Alcohol Review 2017;36(4):527-39.

Otasowie J. Co-occurring mental disorder and substance use disorder in young people: aetiology, assessment and treatment. BJPsych Advances 2021;27(4):272-81.

Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD. Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment 2016;61:47-59.

Yule AM, Kelly JF. Integrating treatment for co-occurring mental health conditions. Alcohol Research: Current Reviews 2019;40(1):arcr.v40.1.07.

Hanuchjarienkul S. Improvement science. Thai Journal of Nursing and Midwifery Practice 2016;3(2):5-14. (in Thai)

Weber MT, Delaney KR, Snow D. Integrating the 2013 Psychiatric Mental Health NP competencies into educational programs: Where are we now? Archives of Psychiatric Nursing. 2016;30(3):425–31. Available from: https://doi.org/10.1016/j.apnu.2015.12.004

Thailand Nursing and Midwifery Council. Criteria for developing specialized nursing training programs and curriculum management, B.E. 2557 [Internet]. 2014 [cited 2025 Oct 6]. Available from: https://www.tnmc.or.th/images/userfiles/files/H007.pdf (in Thai)

American Psychiatric Nurses Association. Psychiatric-mental health nursing: Scope and standards of practice [Internet]. 2014. [cited 2025 Oct 1]. Available from: https://www.apna.org/publications/scope-standards-2

Thailand Nursing and Midwifery Council. Announcement of the nursing council: Scope of practice and competencies of advanced practice nurses in various fields [Internet]. 2009. [cited 2025 Oct 1]. Available from: https://www.tnmc.or.th/images/userfiles/files/H014.pdf (in Thai)

Manitkul N, Thummathai K, Bhatarasakoon P. Factors related to evidence-based practices among mental health nurses in Thailand: A cross-sectional study. Nursing reports. 2024;14(4):3084-96.

Makwichit K, Nukaew O. The development and evaluation of an enhancing empowerment curriculum on self-care behavior among patients with substance-related psychosis for psychiatric. Nurses Journal of Research in Nursing-Midwifery and Health Sciences 2025;45(2):1-15. (in Thai)

De Weert-van Oene GH, Gongora V, von Sternberg K, de Jong CA. Motivation for treatment and motivation for change in substance-dependent patients with co-occurring psychiatric disorders. Journal of Psychoactive Drugs 2015;47(5):393–400. doi: 10.1080/02791072.2015.1079669

Andraka-Christou B, Gordon AJ, Spetz J, Totaram R, Golan M, Randall-Kosich O, et al. Beyond state scope of practice laws for advanced practitioners: Additional supervision requirements for buprenorphine prescribing. Journal of Substance Abuse Treatment 2022;138:108715.

Gary A, Kiper V, Geist R. An introduction to motivational interviewing. Nursing Made Incredibly Easy! 2022;20(2):32-9.

Beck JS. Cognitive behavior therapy: Basics and beyond 2nd ed.: The Guilford Press.; 2011.

Bertrand E, Morvillers JM. Nurses' perceptions of patients with co-occurring psychiatric and substance use disorders in psychiatric settings: A grounded theory study. Journal of Advanced Nursing 2025;81(9):6022-35.

Penzenstadler L, Machado A, Thorens G, Zullino D, Khazaal Y, Effect of case management interventions for patients with substance use disorders: A systematic review. Frontiers in Psychiatry 2017;8:51.

Putra ADM, Sandhi A. Implementation of nursing case management to improve community access to care: A scoping review. Belitung Nursing Journal 2021;7(3):141-50.

Brekke E, Lien L, Biong S. Experiences of professional helping relations by persons with co-occurring mental health and substance use disorders. International Journal of Mental Health and Addiction 2018;16(1):53-65.

Haverfield MC, Ilgen M, Schmidt E, Shelley A, Timko C. Social support networks and symptom severity among patients with co-occurring mental health and substance use disorders. Community Mental Health Journal 2019;55:768-76.