Search results for ‘Subject term:"dual diagnosis"’ Sort:
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The AC-COD Screen: rapid detection of people with the co-occurring disorders of substance abuse, mental illness, domestic violence, and trauma
- Authors:
- CHERRY Andrew L., et al
- Journal article citation:
- Journal of Dual Diagnosis, 4(1), 2007, pp.35-53.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
A 2002 survey by the USA’s Substance Abuse and Mental Health Services Administration found that over 23% of adults with a serious mental illness were also substance abusers, while over 20% of substance abusers had a serious mental illness. This paper discusses the development of an integrated screening instrument based on 17 common behavioural health questions covering mental health, addiction, domestic violence and trauma. Evaluation of the pilot testing of the instrument with 234 people who approached either a mental health or addiction treatment centre shows that the three subscales have acceptable internal consistency. Although further testing is needed, the AC-COD Screen appears to be a promising approach to identifying people likely to have co-occurring disorders who should be fully assessed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Development of a brief screen for substance misuse amongst people with severe mental health problems living in the community
- Authors:
- LEY Ann, et al
- Journal article citation:
- Journal of Mental Health, 16(5), October 2007, pp.679-690.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The only specific screening tool for substance misuse by people with severe mental health problems is the Dartmouth Assessment of Lifestyle Instrument (DALI), which was not developed for use amongst community-based people. The aim was to use the DALI to develop a brief community screen to detect the possibility of harmful substance use (N = 216 people with psychosis). Anglicized versions of the DALI (DALI-UK), and the DALI adapted to accommodate changing patterns of drug use (DALI-MOD) were validated against criterion measures of substance misuse. Data from 160 patients were analysed to find which items best predicted problematic alcohol and drug use. A validation group (n = 56) was used to evaluate the scoring system and develop a short version. Using logistic regression, a single item predicted our criterion measure for alcohol problems and two items predicted our criterion measure for drug problems. We developed the Simple Substance Use Screening Scale (SUSS), which correctly classified 86% of participants for problematic alcohol use (sensitivity 88%, specificity 84%) and 84% for problematic drug use (sensitivity 82%, specificity 84%). Because of its brevity and simplicity, SUSS would be a useful screen for use in routine community mental health practice.
Kat use and mental illness: a critical review
- Authors:
- WARFA Nasir, et al
- Journal article citation:
- Social Science and Medicine, 65(2), July 2007, pp.309-318.
- Publisher:
- Elsevier
Khat has been used as a stimulant plant in many parts of Africa and the Arabian Peninsula for centuries. Its current use among particular migrant communities in Europe and elsewhere has caused alarm among policy makers and health care professionals. In the United Kingdom, the debate over the psychiatric and social implications of khat use has led to a demand for stricter legal control of this stimulant plant. This paper (a) provides a historical overview of khat use, and (b) reviews the evidence for the existence of a causal link between khat use and mental illness. To do so, the authors undertook a detailed search of social and medical science databases for case reports, qualitative and quantitative articles on khat use and mental illness from 1945 to 2006. The validity and reliability of the studies that met the inclusion criteria were examined. Lastly, although highlighting health concerns about khat use the authors suggest that the debate about this popular drug in migrant populations carries elements of a ‘moral panic’. There is a need for improved research on khat use and its possible association with psychiatric disorders.
Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis
- Authors:
- CATON Carol L. M., et al
- Journal article citation:
- British Journal of Psychiatry, 190(2), February 2007, pp.105-111.
- Publisher:
- Cambridge University Press
The stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established. The aim was to describe DSM–IV diagnostic changes over 1 year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction. The authors conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and substance use comorbidity. Of those with a baseline DSM–IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at 1 year also included greater family history of mental illness in the primary psychosis group. Further study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.
Integrated mental health/substance abuse responses to justice involved persons with co-occurring disorders
- Author:
- OSHER Fred C.
- Journal article citation:
- Journal of Dual Diagnosis, 4(1), 2007, pp.3-33.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Many US offenders with mental health problems have co-occurring substance abuse disorders but treatment has typically been fragmented. Integration at both the service and treatment levels is seen as important for the development of evidence-based practice, and research supporting this approach is examined. Specific evidence-based practices are also reviewed including the modified therapeutic community, integrated dual disorder treatment and assertive community treatment. These can involve each of the points of contact with the justice system including the police, the courts, prisons and community-based corrections services. Although increasing numbers of service and treatment integration models are evidence-based, more needs to be done to encourage their implementation in practice. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Substance abuse in early onset psychiatric disorders
- Authors:
- HSIAO Ray, MCCLELLAN Jon
- Journal article citation:
- Journal of Dual Diagnosis, 4(1), 2007, pp.87-99.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Sixty-nine adolescents (mean age 14.8 years) with early onset psychotic disorders were assessed annually over two years using standardised diagnostic and symptom rating instruments. Of these, 39% met criteria for schizophrenia, 45% met criteria for substance abuse disorders, and a further 7% had used illicit substances without meeting the criteria for abuse or dependency. Substance abuse disorders were not significantly associated with the type of psychosis, gender, ethnicity, socioeconomic status, severity of symptoms at baseline or other hypothesised factors. Those with such disorders were significantly older than average on entry to the study. Subjects with co-occurring schizophrenia and substance abuse disorders used substances prior to the onset of their psychosis, and were significantly older when they became ill. Only 26% of the sample had received specific chemical dependency treatment. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Personal social networks of women with co-occurring substance use and mental disorders
- Authors:
- TRACY Elizabeth M., JOHNSON Pamela J.
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 7(1/2), 2007, pp.69-90.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There has been relatively little examination of the social network resources of women with substance use disorder, and even fewer explorations of women with co-occurring mental disorders, such as anxiety, depression, and posttraumatic stress disorder. This American study explores the nature of co-occurring mental disorders, social network characteristics and perceived social support in 136 women with substance use disorders. Respondents reported small personal networks that contained both supportive and non-supportive people. Relatives did provide social support, but those who used alcohol/drugs were viewed as tending to interact negatively. Women with dual disorders perceived less concrete, emotional, and sobriety support from some network relationships than the women with substance use disorders only. Implications for research and practice are presented. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Genotype effects of CHRNA7, CNR1 and COMT in schizophrenia: interactions with tobacco and cannabis use
- Authors:
- ZAMMIT Stanley, et al
- Journal article citation:
- British Journal of Psychiatry, 191(11), November 2007, pp.402-407.
- Publisher:
- Cambridge University Press
Genetic variations might modify associations between schizophrenia and cannabis or tobacco use. The aim was to examine whether variants within the cannabinoid receptor (CNR1) and 7 nicotinic receptor (CHRNA7) genes are associated with schizophrenia, and whether these effects vary according to cannabis or tobacco use. The study also examined a putative interaction between cannabis and Val158Met within the catechol-O-methyltransferase gene (COMT). Genotype effects of CHRNA7 and CNR1 were studied in a case–control sample of 750 individuals with schizophrenia and 688 controls, with interactions for these genes studied in small subsamples. A case-only design of 493 of the schizophrenia group was used to examine interactions between cannabis use and COMT. There was no evidence of association between schizophrenia and CNR1 or CHRNA7 genotypes, or of interactions between tobacco use and CHRNA7, or cannabis use and CNR1 or COMT genotypes. Neither CNR1 nor CHRNA7 variation appears to alter the risk of schizophrenia. Furthermore, the results do not support the presence of different effects of cannabis use on schizophrenia according to variation within COMT.
The challenges of developing dual diagnosis capabilities for acute inpatient staff
- Authors:
- HUGHES Elizabeth, et al
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 2(2), September 2007, pp.36-42.
- Publisher:
- Emerald
This article describes the policy drivers for the improvement of dual diagnosis care in acute psychiatric services, and how two initiatives in London (Camden and Islington and South London Maudsley projects) are overcoming some of the obstacles and showing some promising initial outcomes. The article makes recommendations for future research and developments.
Dual diagnosis of substance abuse and severe mental illness: the scope of the problem
- Author:
- BUCKLEY Peter F.
- Journal article citation:
- Journal of Dual Diagnosis, 3(2), 2007, pp.59-62.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This short paper notes, on the basis of US data, that mental illness and substance abuse co-occur at an alarmingly high rate. Causes may include self-medication, genetic vulnerability, environmental factors or lifestyle, underlying shared origins, or a common neural substrate. The consequences of co-occurring substance abuse include poor medication compliance, physical co-morbidities and poor health, poor self-care, increased suicide or aggression, increased risky sexual behaviour and a higher risk of incarceration. Appropriate screening, assessment and integrated mental health and addiction services for dual diagnosis are key components of care for this complex patient group. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).