Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
10.8 Major clinical issues with somatoform disorders and inhalant/ solvent use
10.8.1 Effects of inhalants/ solvents on somatoform disorders
- There is a dearth of information concerning reports of comorbid inhalant use and somatoform disorders.
- It is likely that the two conditions do not often co-exist because inhalant and solvent use occurs more commonly in younger people and somatoform disorders more frequently occur in older people.
10.8.2 Interactions between inhalants/ solvents and therapeutic agents for somatoform disorders
- The sedative effects of antidepressants, opioids and benzodiazepines may be exacerbated by inhalants and may possibly result in severe sedation and overdosex.
10.8.3 Management approaches to comorbid somatoform disorders and inhalant/ solvent use
- There appears to be no literature that sheds light on managing people with both somatoform disorders and problems relating to inhalant/solvent use.
- As with most other substances, inhalant users should be encouraged to try and reduce or cease use.
- In general, with respect to inhalant/solvent use(65):
- Outline the harms associated with inhalant/solvent use
- Investigate polysubstance use as this is common.
- Standard CBT approaches to both sets of issues should be used, with particular attention to the development of:
- Assertiveness skills (refusal skills).
- Coping skills for controlling and managing emotions such as anger and sadness.
- Offer alternatives to inhalant use, for example, recreational activities.
- Community reinforcement approaches should be developed by mobilising the local health and welfare service system in individual care plans.
- Family interventions need to be considered, for example, increasing communication between the person and the family.
- Assertive outreach and follow-up may be required.