Search results for ‘Subject term:"mental health problems"’ Sort:
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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)
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)
A model of integrated primary care for HIV-positive patients with underlying substance use and mental illness
- Authors:
- ZALLER N., GILLANI F.S., RICH J.D.
- Journal article citation:
- AIDS Care, 19(9), October 2007, pp.1128-1133.
- Publisher:
- Taylor and Francis
There is a high burden of underlying substance use and mental illness in HIV-infected populations. HIV-care settings provide an important opportunity to assess substance and mental health needs among HIV-positive patients and to provide or make referrals for appropriate treatment services. In 2003, with funding from the Center for Substance Abuse Treatment (CSAT), a model of integrated substance-use counselling and referral for treatment was developed within a primary care HIV-care setting at The Miriam Hospital in Providence, Rhode Island. The project uses a multidisciplinary approach to provide linkage to treatment services for substance use and mental illness as well as to help participants with social service needs, such as housing and medical coverage, to ensure continuity of care and optimal HIV treatment adherence. Twelve percent of the 965 HIV-infected patients in care at the center have been enrolled in the project. Of these, all have a current substance-use disorder and 79.3% have been diagnosed with a mental illness. In addition, most participants are hepatitis C-positive (HCV) (65.5%). The majority of participants are on antiretroviral therapy (76.7%). Participants have been referred for the following treatment modalities: intensive outpatient services, methadone, buprenorphine, outpatient services and residential as well as individual and group counselling. The model has been successful in assessing the substance-use and mental health needs of HIV-infected individuals with numerous co-morbidities and referring them for ancillary medical and social services.
Dual diagnosis in mental health inpatient and day hospital settings: guidance on the assessment and management of patients in mental health inpatient and day hospital settings who have mental ill-health and substance use problems
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2006
- Pagination:
- 37p.
- Place of publication:
- London
This guidance covers the assessment and clinical management of patients with mental illness being cared for in psychiatric inpatient or day care settings who also use or misuse alcohol and/or illicit or other drugs. It also covers organisational and management issues to help mental health services manage these patients effectively.
Government moves on in-patient care and dual diagnosis win praise
- Author:
- LEASON Katie
- Journal article citation:
- Community Care, 9.5.02, 2002, pp.14-15.
- Publisher:
- Reed Business Information
The Department of Health has recently published guidance aimed at improving treatment for dual diagnosis patients and adults in acute in-patient care. Mental health charities have welcomed the guidance, but argue that it must be accompanied with additional resources if services are to be improved.
Survey of staff perceptions of illicit drug use among patients in a medium secure unit
- Authors:
- DOLAN Mairead, KIRWAN Helen
- Journal article citation:
- Psychiatric Bulletin, 25(1), January 2001, pp.14-17.
- Publisher:
- Royal College of Psychiatrists
This study is a survey of staff perceptions of illicit drug among in-patients in a medium secure unit. Results showed that sixty per cent of staff were aware of drug misuse on the unit. Less than one-third of staff were clear about the unit's policy for dealing with in-patient drug use and few have had adequate training in the management of patients with dual diagnoses. Strategies for dealing with drug misuse appear to focus on security rather than therapeutic issues. Services need to provide adequate training for staff on the management of patients with co-morbid substance misuse, introduce patient education programmes and develop and disseminate clear policies that emphasise both therapy and security.
Substance use and misuse in psychiatric wards: a model task for clinical governance?
- Authors:
- WILLIAMS Richard, COHEN Jeff
- Journal article citation:
- Psychiatric Bulletin, 24(2), February 2000, pp.43-46.
- Publisher:
- Royal College of Psychiatrists
Substance use has reached endemic proportions. Inevitably, the world of psychiatric wards must reflect issues arising in our society. Recognition of its impact on the psychiatric ward is a key issue for staff and patients alike. This paper discusses the problems of substance use in this setting and suggests some procedures and approaches for dealing with its impact.
Assessing dual diagnosis in an acute in-patient psychiatric unit
- Authors:
- KING Linda Partridge, et al
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 2(4), 1999, pp.19-32.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Dual diagnosis has been a label used to describe the multiple and complex problems of a population that is characterised by two distinct diagnostic entities. This research explores the use of established assessment instruments to identify possible depression and alcohol abuse of dependence. The research also investigates whether the results of these assessments are predictive of the working diagnosis of these individuals in an in-patient treatment unit located in a large urban public hospital. Findings suggest that over 44% of the sample are identified as having possible moderate to severe depression and probable alcoholism. Assessing and recognising the existence of comorbidity is central to effective treatment planning process.
Psychiatric disorders and diabetes mellitus
- Editors:
- LLORENTE Maria D., MALPHURS Julie E., (eds)
- Publisher:
- Informa Healthcare
- Publication year:
- 2007
- Pagination:
- 249p.
- Place of publication:
- Abingdon
Diabetes mellitus is a disease that affects millions of people and their families worldwide, and is increasingly recognized to be a growing public health problem among industrialized nations. Diabetes has been associated with a variety of co-occurring conditions, including cardiovascular disease, elevated lipid serum levels, and more recently, a variety of psychiatric disorders. In addition to this, the disease has also been linked with the pharmacologic treatment of psychiatric disorders. As a result, mental health professionals working in a variety of settings will increasingly encounter patients who have co-occurring psychiatric disorders and diabetes mellitus. Responding to this, this book: includes current evidence-based guideline recommendations regarding the monitoring of metabolic factors in patients being treated with psychotropic agents; reviews the relevant literature to assist the clinician in obtaining multidisciplinary care for their patients; covers the impact of alcohol use and abuse on metabolic factors; discusses the role of diet, nutrition, exercise and motivational therapy in diabetes management; outlines effective models of care that address both diabetes and psychiatric disorders.