ArticleIndian journal of psychiatry2026
How clinicians think about dual disorders: Insights from a case vignette survey.
Article in Indian journal of psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Dual disorders, involving co-occurring mental health and substance use conditions, present diagnostic challenges due to overlapping symptoms. Aim: To assess the diagnostic agreement of mental health professionals in evaluating dual diagnosis cases. Methods: This Cross-sectional study surveyed 73 mental health professionals using two clinical vignettes that depicted common dual disorder scenarios: psychotic symptoms co-occurring with cannabis use and depressive symptoms co-occurring with alcohol use. Participants chose a diagnosis, rated confidence (1-10), and identified influencing factors, along with alternative differentials. Results: For the first case vignette, majority (60.2%) favored schizophrenia with cannabis use over cannabis-induced psychosis, while small number endorsed other psychotic disorders. In the second case vignette, most (89.0%) clinicians preferred major depressive disorder with harmful alcohol use, rather than alcohol-induced mood disorder. Overall confidence agreement was high (average measure ICC = 0.986) despite differences in diagnosis. Conclusion: Although clinicians diagnostic reasoning varied but confidence ratings demonstrated excellent inter - rater agreement (Average ICC = 0.986).
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