Search results for ‘Subject term:"mental health problems"’ Sort:
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Assessment of mental health problems in people with Down syndrome: key considerations
- Author:
- SPENDELOW Jason S.
- Journal article citation:
- British Journal of Learning Disabilities, 39(4), December 2011, pp.306-313.
- Publisher:
- Wiley
Individuals diagnosed with Down syndrome, the most common genetic cause of intellectual disability, are also vulnerable to numerous medical problems. This research review examined the literature relevant to the assessment of psychiatric and behavioural problems in people with Down syndrome. An electronic search was conducted for English-language article published between 1980 and 2010. Search terms included: Down syndrome; psychiatric; depression; anxiety; cognitive; and dementia. Findings revealed that adequate assessment within this population required knowledge, not only of epidemiological findings with respect to psychiatric and behavioural problems, but also an understanding of other important areas including psychometrics, neurocognitive functioning, dementia and other medical issues. The review concluded that a multi-method approach to assessment, using appropriate psychometric tools, is necessary in the assessment of psychiatric and behavioural problems. Further investigation of the behavioural manifestations of underlying medical conditions would assist clinical formulation.
Using information technology to evaluate the detection of co-occurring substance use disorders amongst patients in a state mental health system: implications for co-occurring disorder state initiatives
- Authors:
- HUANG Fredrick Y., et al
- Journal article citation:
- Community Mental Health Journal, 44(1), February 2008, pp.11-27.
- Publisher:
- Springer
The current study describes a system-wide method of evaluating detection strategies for co-occurring disorders within a state mental health system. Information technology was used to merge administrative datasets from the New Jersey mental health and substance abuse systems and identify individuals treated in both systems. The study measured a 53% detection rate of substance use disorders amongst adult patients in the mental health system with particularly low detection rates in acute settings (49.0%) and among female (43.7%), older (36.2%), and psychotic patients (43.6%). The methodology described here could help evaluate critical aspects of ongoing state co-occurring disorder quality improvement initiatives.
Mental health and substance use problems among patients in substance use disorder treatment as reported by patients versus treatment personnel
- Authors:
- BERGLY Tone H., HAGEN Roger, GRAWE Rolf W.
- Journal article citation:
- Journal of Substance Use, 20(4), 2015, pp.282-287.
- Publisher:
- Taylor and Francis
Objective: This study examines and compares mental health and substance use problems among patients in substance use disorder treatment as reported by both patients and treatment personnel, and explores the feasibility of the quadrant model in addressing severity of mental health and substance use based on reports by treatment personnel. Methods: Patients receiving inpatient substance use treatment at clinics in Norway were recruited for the study; 85 completed a cross-sectional survey. Treatment personnel completed a separate survey and gathered information from patient charts. Results: While there were minor differences in the patient and personnel reported prevalence of mental disorders in general (34 and 41%, respectively), there were significant differences in reported affective disorders and personality disorders. Based on the quadrant model, 70.2% of the patients had a high severity of substance use and low severity of mental health problems, while 21.4% had high severity of both. Conclusions: The differences in reports of mental disorders are important, and future research should aim to increase the validity and reliability of reported mental health problems among patients with substance use disorders. The quadrant model does seem to be a feasible model in addressing the severity of such co-occurring disorders. (Edited publisher abstract)
The 10 most important debates surrounding dual diagnosis
- Author:
- HAMILTON Ian
- Journal article citation:
- Advances in Dual Diagnosis, 7(3), 2014, pp.118-128.
- Publisher:
- Emerald
This paper reflects on the progress made to date in advancing knowledge and understanding of the relationship between substance use and mental health. The author draws on the available literature, identifying key contributions from a variety of fields which have helped to shape the understanding of the issues in relation to dual diagnosis. The ten key themes are identified: the definition of the term dual diagnosis; prevelence and incidence; assessment; cognitive functioning; the reasons behind the relationship between substance misuse and mental health; contrasting perspectives; integrated care; identity and stigma; staff attitudes; and philosophy of treatment. (Edited publisher abstract)
Assessment of deaf dually diagnosed clients
- Authors:
- WALLS Rebecca, HAMILTON Ian
- Journal article citation:
- Advances in Dual Diagnosis, 5(1), 2012, pp.32-37.
- Publisher:
- Emerald
It is estimated that about 40% of deaf people will experience a mental health problem at some point in their life compared with 25% of the general population. There have also been suggestions that substance misuse may be greater in the mentally ill deaf population compared with the hearing mentally ill population. This article explores assessment issues for deaf people who have a co-occurring mental health and substance use problem. It draws on the expertise of a clinician who works with this client group and the available literature on the topic. Dual diagnosis for Deaf British Sign Language (BSL) users has not been well researched. Deaf people may be unable to access some forms of assessment/treatment due to compromised cognition, understanding of concepts, and material not being accessible in an appropriate format. The authors consider an approach which may be of particular use in assessing this minority group. Although current techniques can be adapted such as cognitive-behavioural integrated treatment (C-BIT), there is a need for further research to evaluate and develop appropriate screening and assessment instruments for this client group.
Bipolar disorder and substance abuse: two disorders or one?
- Author:
- SWANN Alan C.
- Journal article citation:
- Journal of Dual Diagnosis, 1(3), 2005, pp.9-23.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The aim was to review evidence about mechanisms and consequences of relationships between bipolar and substance use disorders. Articles were identified using a MEDLINE search linking (1) bipolar disorder to substance use disorders, alcoholism, and specific drugs, (2) bipolar disorder and substance abuse to treatment strategies, and (3) bipolar disorder or substance abuse to behavioral sensitization, impulsivity, and suicide. We attempted to select only the most relevant refereed articles. In addition to articles found in the search, key references cited in the articles were used. Substance use disorders and bipolar disorders are associated with mutually increased risk. Patients with the combination are more impulsive and are at greater risk for suicidal or violent behavior than are subjects with either illness alone. Compared to subjects with bipolar disorder who do not have a substance use disorder, those with combined disorders have earlier onset of illness, more frequent hospitalizations, and are more likely to experience mixed episodes. Both disorders must be addressed specifically for treatment to be effective. Treatment options are expanding, but few have been adequately studied. The nature of the apparent link between bipolar disorder and substance use disorders suggests that they share common mechanisms. Candidate mechanisms include abnormal regulation of the initiation of behavior leading to abnormal reward sensitivity and increased impulsivity, and increased susceptibility to behavioral sensitization.(Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Comparison of the internal state scale to clinician-administered assessments in patients with bipolar disorder and alcohol abuse or dependence
- Authors:
- SRISINROONGRUANG Rattapol, et al
- Journal article citation:
- Journal of Dual Diagnosis, 1(3), 2005, pp.61-69.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Self-report measures require less clinician time to administer than clinician-rated assessments. The Internal State Scale (ISS) is a well-validated self-report measure that assesses symptoms of mania and depression in patients with bipolar disorder (BPD). However, the ISS has never been specifically evaluated in patients with BPD and comorbid substance misuse. Substances can induce mood symptoms complicating diagnosis and mood state assessment. The ISS was compared with the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS) in 21 patients with BPD and alcohol abuse/dependence at baseline and for up to 16 weeks postbaseline. In addition, ISS-determined mood state was compared to mood state from a structured diagnostic interview. Significant baseline correlations were observed between the ISS depression subscale and HRSD, ISS activation subscale and YMRS, and ISS perceived conflict subscale and BPRS. Significant correlations of baseline to exit change scores were found between the ISS activation and YMRS, but not ISS depression and HRSD, or ISS perceived conflict and BPRS. All participants had a mixed mood state by structured diagnostic interview. The ISS diagnosed the manic/hypomanic portion of this mood state in 76% of participants but found depression in only 38%. As in BPD patients without substance abuse, the ISS generally showed correlations with clinician-rated scales at baseline, with less strong correlations observed on change scores. The ISS diagnosis of mania or hypomania appeared to correspond more highly than depression with the findings from a structured diagnostic interview.(Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Dual diagnosis: developing a practical tool kit
- Author:
- HAWKINS Caroline
- Journal article citation:
- Mental Health Review, 10(2), June 2005, pp.15-18.
- Publisher:
- Pier Professional
The number of people with both mental health and substance abuse problems rose bhy 60 per cent between 1993 and 1998. A toolkit produced by Turning Point and Rethink with funding from the Home Office has been produced with the aim of addressing the challenges for both mental health and substance misuse professionals. This article highlights the core principles and guidelines from the toolkit designed to ensure effective treatment and support for service users. A case study of the Barnet Dual Diagnosis Steering Group is also included.
The utility of DSM-IV criteria in diagnosing substance abuse/dependence in adolescents
- Authors:
- DEAS Deborah, ROBERTD James S., GRINDLINGER Dani
- Journal article citation:
- Journal of Substance Use, 10(1), February 2005, pp.10-21.
- Publisher:
- Taylor and Francis
The purpose of this study was to explore the utility of DSM-IV criteria in diagnosing alcohol and marijuana abuse/dependence in adolescents. A modified version of the Structured Clinical Interview for DSM-IV (SCID) was administered to assess substance abuse/dependence symptoms in 127 inpatient, treatment-seeking adolescents with substance-use disorders. The proportion of individuals with clinically relevant symptoms was examined separately for individuals classified with either abuse or dependence. Chi-square tests of independence between the abusive/dependent classification and the presence/absence of a given symptom were also performed. Rates of DSM-IV current substance use diagnoses were alcohol abuse 21 (16%), alcohol dependence 44 (35%), marijuana abuse 27 (21%) and marijuana dependence 72 (57%). A diagnosis of marijuana dependence was significantly more likely when tolerance symptoms were present but was not significantly dependent on the presence of withdrawal symptoms. By contrast, the presence of both tolerance and withdrawal symptoms were indicative of alcohol dependence. There was a high degree of heterogeneity of DSM-IV dependence symptoms for both alcohol and marijuana dependence. Our study suggests that the DSM-IV criteria have limitations in diagnosing substance-use disorders in adolescents. A modified version of the SCID may be useful in the adolescent substance use population.
Mental health, substance use, and criminal justice characteristics of males with a history of abuse in a Swedish national sample
- Journal article citation:
- Journal of Dual Diagnosis, 9(1), 2013, pp.47-60.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: The primary goals of this study were to (a) provide the first estimate of prevalence of self-reported history of having been emotionally, physically, and/or sexually abused for men with a substance use disorder in Sweden and (b) identify, for men with a substance use disorder, mental health, substance use, and criminal justice characteristics associated with having a history of abuse. Methods: Assessment interviews for a substance use disorder were conducted in 50 out of 300 Swedish counties for the time period 2003 to 2008. Participants were a nationally representative sample of 9,571 Swedish men interviewed in county welfare offices. The Addiction Severity Index (ASI) was used as an assessment tool in these counties. From the ASI, answers to questions asking about lifetime history of emotional, physical, and sexual abuse were analyzed to provide this initial measure on history of abuse. Bivariate statistical analysis and multivariate logistic regression methods were used to explore the relationships between substance use severity, level of mental health problems reported, criminal justice history, and history of being abused. Results: Overall, 47.9% of the men in this sample reported having experienced abuse; specifically, 26.9% of clients reported a history of physical abuse, 4.5% reported a history of sexual abuse, and 40.7% reported a history of emotional abuse. Results from logistic regression modeling identified that higher ASI mental health symptomology scores were associated with 13 times higher likelihood of having experienced any abuse. Further, results from logistic regression models identified that scoring higher on the ASI mental health symptoms core was associated with an 8 times higher likelihood of having experienced physical abuse,14 times higher likelihood of having experienced sexual abuse, and 13 times higher likelihood of having experienced emotional abuse. Conclusions: Both the high prevalence of reporting a history of abuse among men with substance use disorders and the strong association between reporting more mental health symptoms and history of abuse indicate a need for Swedish substance use disorder treatment programmes to start using more comprehensive and clinically appropriate trauma assessment tools and to provide empirically supported trauma treatments. (Publisher abstract)