Search results for ‘Subject term:"mental health problems"’ Sort:
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Prevalence and trajectories of psychiatric symptoms among sober living house residents
- Authors:
- POLCIN Doug, et al
- Journal article citation:
- Journal of Dual Diagnosis, 12(2), 2016, pp.175-184.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: Sober living houses are alcohol- and drug-free recovery residences that help individuals with substance use disorders maintain long-term abstinence. Given the prevalence of co-occurring mental disorders among individuals entering substance use treatment, it is likely that many such residents are also contending with psychiatric symptoms, and it is unclear how these symptoms may affect their sobriety. This study sought to describe the prevalence and trajectories of different types of symptoms among sober living house residents and examine how these symptoms affect substance use outcomes. Methods: Data for this study were collected as part of a larger study on outcomes among sober living house residents in Northern California. The current study examined data from 300 residents in two housing groups; residents were interviewed upon entry and re-interviewed at 6-, 12-, and 18-month follow-ups. Psychiatric symptoms were assessed using the Brief Symptom Inventory (BSI). General estimating equations tested changes in BSI global psychological distress and clinical symptom scales over time and examined the relationship between scale scores and substance use in longitudinal models controlling for demographics, length of stay, and psychiatric service utilisation. Results: The average age of residents was 38.5 years, and they were mostly male (80%) and Caucasian (65%). Retention rates were high, with 90% participating in at least one follow-up interview. Overall psychological distress, symptoms of depression, and phobic anxiety significantly improved over time. In all models examining the relationship between BSI scale scores and substance use, rates of abstinence and days of use among those who reported using substances also improved over time. Overall distress as well as higher scores on the somatization, depression, hostility, and phobic anxiety subscales were significantly associated with a decreased likelihood of abstinence. Symptoms of somatization were associated with an increase in the number of days substances were used among those who reported use. Conclusions: Psychological symptoms among sober living house residents improve over time, but they are risk factors for relapse, suggesting that additional support provided to residents with psychiatric symptoms could improve substance use outcomes. (Edited publisher abstract)
A six-year study of substance use and mental health disorders: ascertaining the prevalence of comorbidity
- Authors:
- LAI Harry Man Xiong, SITHARTHAN Thiagarajan
- Journal article citation:
- Drugs and Alcohol Today, 12(3), 2012, pp.180-186.
- Publisher:
- Emerald
Comorbidity in substance use disorders (SUDs) and mental health disorders (MHDs) is common and widespread. It is also associated with poor treatment outcomes, severe illness course and high-service utilisation. Characteristics of substance use disorders (SUDs) comorbid with mental health disorders (MHDs) are not completely clear in early population based studies. The objective of this paper is to examine the association of SUDs comorbid with MHDs and vice-versa using a large inpatient dataset. The data, from July 2001 to June 2007, were extracted from the New South Wales Inpatient Statistic Data Collection. There was a total of 10,211,596 admissions. Over the six years, between 9.4% and 12.6% of the patients with MHDs were diagnosed as having SUDs. Of the patients diagnosed with SUDs, between 42.5% and 57.4% also had a diagnosis of MHDs. Overall, the comorbidity for both MHDs and SUDs was between 8.4% and 11.3%. The authors concluded that the findings imply that different efforts towards the prevention, care and management of comorbidity may be warranted.
Nine-year psychiatric trajectories and substance use outcomes: an application of the group-based modeling approach
- Authors:
- CHI Felicia W., WEISNER Constance M.
- Journal article citation:
- Evaluation Review, 32(1), February 2008, pp.39-58.
- Publisher:
- Sage
This study identifies longitudinal psychiatric trajectories of 934 adult individuals entering chemical dependency treatment in a private, managed care health plan in the US and examines the relationship of these trajectories with substance use (SU) outcomes. The authors apply a group-based modelling approach to identify trajectory groups based on repeated measures of psychiatric severity for 9 years and identify four distinct groups. Results of multivariate logistic generalized estimating equation models find an association between psychiatric trajectories and long-term SU. Older cohorts and life course measures of marital status and employment status as individuals changed over time are related to drug and some alcohol outcomes.
The interaction of co-occurring mental disorders and recovery management checkups on substance abuse treatment participation and recovery
- Authors:
- RUSH Brian R., et al
- Journal article citation:
- Evaluation Review, 32(1), February 2008, pp.7-38.
- Publisher:
- Sage
This article examines the effectiveness of quarterly Recovery Management Checkups (RMCs) for people with substance disorders by level of co-occurring mental disorders (34% none, 27% internalizing disorders, and 39% internalizing and externalizing) across two randomized experiments with 92% to 97% follow-up. The 865 participants are 82% African American, 53% female, and age 37 on average. RMC involves identification of those in need of treatment, motivational interviews, and treatment linkage assistance. It is effective in linking participants in need to treatment, with equal or better outcomes among those with more mental disorders. The data support the utility of monitoring and re-intervention for clients with co-occurring disorders.
Preliminary outcomes from a community linkage intervention for individuals with co-occurring substance abuse and serious mental illness
- Authors:
- SMELSON David A., et al
- Journal article citation:
- Journal of Dual Diagnosis, 1(3), 2005, pp.47-59.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Few interventions assist individuals with a mental illness and a co-occurring substance abuse disorder in the transition from hospitalization to outpatient treatment. This change in care is often abrupt, resulting in fragmented treatment that jeopardizes recovery. This article reports on the preliminary outcomes from a new eightweek linkage intervention entitled “Time-Limited Case Management (TLC)” that integrates intensive outreach, Dual Recovery Therapy (DRT), and peer support to facilitate outpatient treatment engagement following discharge from Acute Psychiatry. This eight-week naturalistic feasibility study included 59 recently hospitalized subjects with a mental illness and substance abuse disorder who were offered the new service. The individuals who agreed to receive TLC (n = 26) formed the treatment group and those who refused (n = 33) made up the comparison group. The TLC service was successfully implemented into the system and improved the transition from inpatient to outpatient care. The individuals who received the TLC intervention had a higher show rate at the Day Treatment Center intake appointment, attended more days of treatment at the Day Center, had greater pharmacy refill compliance, and were less likely to be lost to follow-up at eight weeks than the comparison group. TLC represents a promising new approach to maintaining continuity in care following psychiatric hospitalization that may be easily implemented in other systems. We are currently in the process of developing an implementation manual and doing a large randomized controlled trial to determine whether the intervention improves substance abuse and psychiatric outcomes in addition to facilitating treatment engagement.(Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Are computer-based treatment programs effective at reducing symptoms of substance misuse and mental health difficulties within adults? A systematic review
- Authors:
- DUGDALE Stephanie, et al
- Journal article citation:
- Journal of Dual Diagnosis, 15(4), 2019, pp.291-311.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: Comorbid substance misuse and mental health difficulties are recognized as a leading contributor to disease burden worldwide. Amid cuts to health care services, computer-based interventions may provide support for patients experiencing these difficulties. The aims of this systematic review were to identify and investigate the efficacy of these computer-based interventions at improving substance misuse and mental health outcomes. Methods: A systematic search was conducted of CINAHL Plus, PsycARTICLES, PsycINFO, Medline, Web of Science, and the Cochrane Library. Gray literature was also searched for relevant papers. Data were extracted from 33 papers, which met eligibility criteria by reporting a computer-based intervention designed to treat substance misuse and mental health in adults. Quality assessments were conducted on these papers. Results: Computer-based interventions generally led to an improvement of substance misuse and mental health outcomes within groups and when compared against waitlist control and psychoeducation. Computer-based interventions were effective at improving dual diagnosis outcomes, and improvements to mental health outcomes specifically were maintained for up to nine months. However, the combined effect of computer-based interventions and therapist support was found to be more effective than the effects of computer-based interventions alone. Conclusions: Many papers were limited by high attrition rates commonly attributed to “digital” interventions. Future research should consider systematically recruiting a range of participants, including those potentially affected by the digital divide, and incorporating methods within research to maintain engagement. This review was also limited by the heterogeneity of the papers reported, many of which differed between targeting dual diagnosis and targeting either substance misuse or mental health respectively, with outcomes investigating other difficulties out of curiosity. (Publisher abstract)
Impact of physical health on treatment for co-occurring depression and substance dependence
- Authors:
- TRIPP Jessica C., et al
- Journal article citation:
- Journal of Dual Diagnosis, 9(3), 2013, pp.239-248.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: There is a high rate of comorbidity among substance dependence, depression, and physical health problems. This study aimed to examine the impact of pre-treatment physical health stressors (acute and chronic conditions) on outcomes of treatment in a sample of veterans with dual disorders (depression and substance dependence) who were randomised to integrated cognitive behavioural therapy versus 12-step interventions. Methods: This study included 205 veterans (89.8% male, mean age = 49.5 years) enrolled in a clinical treatment outcomes trial. Chronic health problems (persistent, ongoing conditions lasting 2 weeks or more; e.g., arthritis, diabetes) and acute health events (occurring on a discrete date; e.g., injury, surgery, myocardial infarction) were coded dichotomously (presence versus absence) and evaluated separately. The impact of physical health stressors on abstinence (defined dichotomously), percentage of days abstinent, and depression symptoms were analyzed at the end of 12 and 24 weeks of treatment. Additionally, associations between intake motivation to change, health stressors, and substance use were examined. Results: Analyses revealed that participants who had experienced a pre-treatment acute health event had higher rates of abstinence at 12 weeks, higher percentage of days abstinent at 24 weeks, and higher depression symptoms at intake. Participants with chronic health difficulties had more severe depression at intake and those participants with severe chronic difficulties had greater depression symptoms across all time points. Chronic health difficulties were related to the “taking steps” factor of motivation to change substance use, but acute health events were not related to motivation to change. Motivation to change was also not related to substance outcomes in our sample. Conclusions: Physical health appears to have a complex relationship with co-occurring depression and substance dependence. Acute health problems predicted lower substance use, whereas chronic health problems were associated with higher depression levels. Explicitly addressing the connection between substance use and health events during treatment may improve addiction treatment outcomes. However, individuals with chronic health problems may benefit from extending treatment or adjunct strategies focused on addressing chronic health concerns. This is an analysis of data collected as part of a clinical trial registered at www.ClinicalTrials.gov as NCT00108407. (Publisher abstract)
Impact of dual disorders, trauma, and social support on quality of life among women in treatment for substance dependence
- Authors:
- BROWN Suzanne, et al
- Journal article citation:
- Journal of Dual Diagnosis, 9(1), 2013, pp.61-71.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: Women with dual disorders report lower levels of social support than women with substance dependence alone, and lower levels of social support have been associated with lower quality of life among individuals with substance use disorders. However, little is known about the impact of trauma symptoms and violence exposure on quality of life for women with dual disorders. The purpose of this study was to examine the impact of dual disorders, trauma, and social support related to recovery on various domains of quality of life among women in substance abuse treatment. Methods: This study utilised multiple standardised measures and hierarchical ordinary least squares regression to examine quality of life, trauma, and social support in women with dual disorders. Four domains of quality of life were measured (physical, psychological, social, and environmental domains). Participants (N = 369) were recruited from three inner-city women-only addiction treatment programmes. Institutional review board approval was obtained prior to sample recruitment. Results: Presence of dual disorders was significantly associated with lower quality of life in the physical and psychological domains. However, this difference was no longer significant when trauma symptoms were added to the model. Trauma symptoms and support for recovery significantly predicted quality of life across all four domains and friends’ support for abstinence across three domains. Conclusions: Findings suggest that the presence of dual disorders in women may indicate a history of trauma. They also support the importance of both friends’ support for abstinence and recovery support as predictors of quality of life in women with dual disorders. Interventions that focus on social support and quality of life in treatment with women with substance use disorders may potentially enhance treatment outcomes. (Publisher abstract)
Substance abuse recovery after experiencing homelessness and mental illness: case studies of change over time
- Authors:
- HENWOOD Benjamin, et al
- Journal article citation:
- Journal of Dual Diagnosis, 8(31), July 2012, pp.238-246.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The authors examined how consumers with dual diagnosis who were formerly homeless, but now living in supportive housing, understand their recovery from substance abuse or dependence. Their aims were to discover what can be learned about substance misuse recovery from consumers considered to be doing well, how past substance abuse fits into their present-day narratives, and how policies of harm reduction versus abstinence are considered to affect recovery efforts. As part of a federally funded study in New York, 38 individuals (84% male, mean age 51 years) who met criteria for having achieved a measure of success in mental health recovery were purposively sampled from two supportive housing agencies; one using harm reduction and the other an abstinence model. In-depth interviews and case study analysis were used to focus on substance abuse recovery in the larger context of participants’ lives. Recovery from substance abuse was depicted as occurring either through discrete decisions or gradual processes; achieving recovery was distinct from maintaining recovery. Themes related to achievement included: pivotal events and people; maturation; institutionalisation. Central themes to maintaining recovery were: housing; self-help; the influence of significant others. These findings revealed a complex picture of overcoming substance abuse that largely took place outside formal treatment and was heavily dependent on broader contexts.
Service utilization patterns as predictors of response to trauma-informed integrated treatment for women with co-occurring disorders
- Authors:
- GILBERT Allison R., MORRISSEY Joseph P., DOMINO Marisa E.
- Journal article citation:
- Journal of Dual Diagnosis, 7(3), July 2011, pp.117-129.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Women with substance use disorders and with mental health disorders are at high risk for physical and sexual abuse. The aim of this study was to examine whether clinical responses to an integrated treatment intervention among women with co-occurring disorders and histories of abuse varied according to their service use patterns prior to study entry. The study was the Women’s Co-occurring Disorder and Violence Study conducted 1998 to 2003. Analyses for this paper included 999 study participants assigned to the integrated treatment group. The findings showed that participants with high levels of psychotropic medication and medical care use at baseline had significantly lower odds than low-intensity service users of having a good response to integrated treatment at 12 months on mental health, alcohol addiction, and posttraumatic stress measures. A majority of women in this group had serious medical problems and were more likely than their counterparts with other service use patterns to have used homeless or domestic violence shelters. The article concludes that women who used high levels of medication and medical services appear to face especially difficult barriers in responding well to integrated treatment. This information can also be used to target integrated treatment to women who are likely to respond positively and achieve meaningful improvements in their functioning.