Search results for ‘Subject term:"dual diagnosis"’ Sort:
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LETS ACT: a behavioral activation treatment for substance use and depression
- Authors:
- DAUGHTERS Stacey B., et al
- Journal article citation:
- Advances in Dual Diagnosis, 9(2/3), 2016, pp.74-84.
- Publisher:
- Emerald
Purpose: Substance use disorders (SUDs) often co-occur with major depressive disorder (MDD), yet treatments targeting this comorbidity are limited, especially in resource-limited settings where individuals with SUDs often receive treatment. The paper aims to discuss this issue. Design/methodology/approach: Based upon principles of reinforcement and behavioural economic models of substance use, as well as the Brief Behavioral Activation Treatment for Depression (Lejuez et al., 2011), the Life Enhancement Treatment for Substance Use (LETS ACT) (Daughters et al., 2008) was developed to meet the unique needs of patients with MDD-SUD comorbidity. Findings: This paper presents a summary of the theoretical foundations and key components of LETS ACT. Originality/value: A specific focus on increasing dissemination via the flexible delivery dependent on patient and treatment setting characteristics is provided throughout. (Edited publisher abstract)
Smoking and depression: a co-morbidity
- Authors:
- BERLIN Ivan, COVEY Lirio S., GLASSMAN Alexander H.
- Journal article citation:
- Journal of Dual Diagnosis, 5(2), April 2009, pp.149-158.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This literature review, based on searches of PubMed for a ten year period, shows that depression (defined as depressive mood, major depressive disorder or negative affect) increases the risk of smoking, and vice versa. The relationship between depression and smoking cessation is less clear, with some clinical and epidemiological studies concluding that depression has an impact on the ability to quit and others showing no such association. Research has also strongly suggested that commonality in genetic and environmental factors underlies the co-morbidity of smoking and depression, although the specific mechanisms have yet to be identified. The authors conclude that the relationship between depression and smoking is firmly established and that reciprocal relationships between the two are strongly suggested although requiring further investigation.
Does a history of alcohol use disorder affect response to antidepressant medication in patients with dysthymic disorder?
- Authors:
- ARNAOUT Bachaar, et al
- Journal article citation:
- Journal of Dual Diagnosis, 4(4), 2008, pp.377-393.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study is based on secondary analysis of clinical trial data and covers 123 participants with dysthymic disorder (a type of depression). Of these, 99 had no history of alcohol use disorder while 24 did although no participant met the criteria for this disorder in the six months prior to the study. After eight weeks of antidepressant treatment, the two groups did not differ in rates of response or remission despite significantly higher baseline depression scores in the alcohol use disorder group. This group also experienced a greater reduction in symptoms. Dysthymic disorder is therefore judged to be as responsive to drug treatment among remitted alcoholics as among non-alcoholics. Further research to confirm the results is warranted. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Divorce was cue for mental health decline
- Author:
- -
- Journal article citation:
- Community Care, 22.1.09, 2009, pp.30-31.
- Publisher:
- Reed Business Information
Social workers and a service users offer advice on a case involving excessive alcohol use and depression.
Substance abuse and psychiatric dual disorders: focus on tobacco
- Authors:
- GOLD Mark S., FROST-PINEDA Kimberley
- Journal article citation:
- Journal of Dual Diagnosis, 1(1), 2004, pp.15-35.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Smoking is a leading cause of morbidity and is the single most important preventable cause of mortality in the United States. The link between tobacco smoking and lung cancer, heart disease, stroke, chronic lung disease, other cancers, and other medical diseases is now generally accepted. The link between tobacco and psychiatric diseases has become a focus for recent epidemiological studies, which have even led to the suggestion that in the differential diagnosis of "smoker" highest on the list are depression, alcohol dependence, and schizophrenia. Less is known about the role of second hand tobacco exposure, either in utero or during childhood, in the risk of dual disorders. Here the authors explore the issue of substance abuse and psychiatric dual disorders, prenatal and early childhood Second Hand Smoke (SHS) exposure and the relationship to the genesis of these dual disorders. They describe a novel method of detecting SHS exposure and the public health implications of this development. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Dual diagnosis: discovery of a critical role for environmental exposure
- Author:
- GOLD Mark S.
- Journal article citation:
- Journal of Dual Diagnosis, 1(1), 2004, pp.5-13.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
It is estimated that 10 million persons in the United States have at least one mental disorder and at least one substance-related disorder in any given year. Dual disorders are common in psychiatry, but misdiagnosis may be even more common. Drug and alcohol testing should be expanded from routine use in the Olympics and intercollegiate athletics to psychiatric diagnosis of drug intoxication, dependence, and withdrawal states. Major Depression is co-morbid with opiate addiction, alcohol dependency, tobacco smoking, and many other substance abuse disorders. Drug use induces adaptations in brain systems associated with mood and motivation. The acute rewarding effects of drugs change the mesolimbic dopaminergic system. Cessation of drug self-administration induces dysphoria and anhedonia as a result of changes in monoamine levels in brain reward circuits; opposite to the effects that occur after the administration of drugs of abuse. While most models for dual disorders assume compulsive or volitional use or self administration, we have been interested in second-hand exposure which was common in the past among flight attendants and occurs today between smoking parent and child. We expand the concept from parent-to-child environmental tobacco toxicity to a workplace toxicity hypothesis for anesthesiologists. Such a hypothesis can explain the high rates of depression, workplace and social distress, drug abuse, and drug addiction among anesthesiologists. While co-occurring disorders have been the focus of epidemiological studies and twin and genetic studies, the role of exposure to potent drugs of abuse in the intra-uterine, home, and workplace environment has been neglected. We have demonstrated the unequivocal presence of fentanyl and other potent drugs of abuse in the air that anesthesiologists breathe in the operating room. Drug exposure sensitizes the brain. When sensitization is coupled with the stress of operating room, employment may produce the pattern of co-occurring disorders seen in anesthesiologists but not psychiatrists. Prevention is the goal in environmental or toxicity-related illness. After diagnosis, treatment for dual disorders should be vigorous with remission of all disorders in mind. For anesthesiologists, limiting toxic environmental exposure may prevent both drug and affective disorders. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Factors associated with smoking and smoking cessation among primary care patients with depression: a naturalistic cohort study
- Authors:
- GILCHRIST Gail, et al
- Journal article citation:
- Advances in Dual Diagnosis, 8(1), 2015, pp.18-28.
- Publisher:
- Emerald
Purpose: People with a history of depression are more likely to smoke and less likely to achieve abstinence from smoking long term. The purpose of this paper is to understand the factors associated with smoking and smoking cessation among patients with depression. Design/methodology/approach: This paper reports on smoking prevalence and cessation in a cohort of 789 primary care attendees with depressive symptoms (Centre for Epidemiologic Studies Depression Scale score of=16) recruited from 30 randomly selected Primary Care Practices in Victoria, Australia in 2005. Findings: At baseline, 32 per cent of participants smoked. Smokers were more likely to be male, unmarried, receive government benefits, have difficulty managing on available income, have emphysema, a chronic illness, poor self-rated health, to have more severe depressive and anxiety symptoms, to be taking anti-depressants, to be hazardous drinkers, to report suicidal ideation and to have experienced childhood physical or sexual abuse. At 12 months, 20 participants reported quitting. Females and people with good or better self-rated health were significantly more likely to have quit, while people with a chronic illness or suicidal ideation were less likely to quit. Smoking cessation was not associated with increases in depression or anxiety symptoms. Only six participants remained quit over four years. Practical implications: Rates of smoking were high, and long-term cessation was low among primary care patients with depressive symptoms. Primary care physicians should provide additional monitoring and support to assist smokers with depression quit and remain quit. Originality/value: This is the first naturalistic study of smoking patterns among primary care attendees with depressive symptoms. (Publisher abstract)
Depression and anxiety symptoms: measuring reliable change in alcohol and drug users
- Author:
- DELGADILLO Jaime
- Journal article citation:
- Advances in Dual Diagnosis, 5(3), 2012, pp.102-114.
- Publisher:
- Emerald
The aim of this study, based on a sample drawn from a project investigating the prevalence and assessment of depression and anxiety in alcohol and drug users, was to describe and compare the reliability and accuracy of different methods of measuring psychiatric symptom changes in the context of substance use. The participants were 60 patients in routine methadone treatment at an inner city addictions treatment clinic in Leeds. Information was gathered through screening questionnaires for depression and anxiety and structured diagnostic interviews, with a follow-up retest after a "watchful wait" period of 4 to 6 weeks. The article describes the study methodology and data analysis, and presents and discusses the results. It reports that measuring change using conventional cut-offs in brief symptom questionnaires tends to overestimate the prevalence of common mental disorders and the rate of improvement, and discusses the relative merits and limitations of alternative psychiatric symptom measurement methods which may improve accuracy and enhance reliability.
Alcohol use disorders and the course of depressive and anxiety disorders
- Authors:
- BOSCHLOO Lynn, et al
- Journal article citation:
- British Journal of Psychiatry, 200(6), June 2012, pp.476-484.
- Publisher:
- Cambridge University Press
Few prospective studies have looked at the effects of alcohol use disorders on the natural course of depression and anxiety and the data are conflicting. This study was designed to determine whether the course of depressive and/or anxiety disorders is conditional on the type (abuse or dependence) or severity of comorbid alcohol use disorders. The impact of the presence and severity of DSM-IV alcohol abuse or alcohol dependence on the 2-year course of depressive and/or anxiety disorders was examined in a large sample of participants with current depression and/or anxiety (n = 1369, mean age 41 years, 66% female). The data were derived from an ongoing study of depression in the Netherlands. The persistence of depressive and/or anxiety disorders after 2 years was significantly higher in those with remitted or current alcohol dependence (persistence 62% and 67% respectively), but not in those with remitted or current alcohol abuse (persistence 51% and 46% respectively), compared with no lifetime alcohol use disorder (persistence 53%). Severe but not moderate current dependence was a significant predictor as 95% of those in the former group still had a depressive and/or anxiety disorder at follow-up. It is concluded that alcohol dependence, especially severe current dependence, is a risk factor for an unfavourable course of depressive and/or anxiety disorders, whereas alcohol abuse is not.
The utility of a developmentally based quadrant classification model of co-occurring substance use and depressed mood in adolescents
- Authors:
- STEWART David G., et al
- Journal article citation:
- Journal of Dual Diagnosis, 7(3), July 2011, pp.130-140.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
It is not clear whether the co-occurrence of mental health and substance use disorders among adolescents, rather than single disorders, has an impact on service utilisation and clinical presentation. A tool developed for the classification of co-occurring disorders across service delivery systems is the quadrant model. The purpose of this study was to investigate the utility of the quadrant classification of co-occurring substance use and depressed mood in adolescents. The addition of developmentally risky but diagnostically sub-threshold symptoms was hypothesised to improve the utility of co-occurring disorder classification. Data was drawn from the 2008 National Survey of Drug Use and Health. A total of 17,489 12- to 17- year olds who participated in the survey were classified by severity of depression and substance abuse symptoms into single and co-occurring disorder groups. The article concludes that the quadrant model is appropriate for adolescents. Lowering the depression and substance use thresholds for categorising adolescents as having co-occurring disorders maintained the utility of the quadrant model co-occurring disorders classification system and marginally improved the prediction of service utilisation.