Pub Date : 2025-03-27DOI: 10.1080/15504263.2025.2478893
Glenn Sterner, Michael B Lavetsky, Matthew J Ercolani, Kayla Lopez
Objective: This study examined behavioral health clinician perceptions at the beginning stages of the COVID-19 pandemic regarding their preparedness, training, and effectiveness in delivering telehealth to adults and adolescents in substance use and mental health settings. Methods: Data were collected through an anonymous online survey of 241 behavioral health practitioners in Pennsylvania from November 17, 2020, to January 3, 2021. Quantitative descriptive and qualitative analyses on survey results are presented. Results: Clinicians believed they were effective in their delivery of therapeutic services through telehealth modalities. However, they noted key training needs for delivering telehealth. Results indicate greater difficulty in delivering telehealth to adolescent clients and those with substance use. Practitioners indicate that telehealth allows greater access to treatment. Conclusions: Researchers recommend increasing training for practitioners and conducting training for patients. Policies should be reconsidered and address the changing landscape of behavioral health service provision.
{"title":"Mental Health and Substance Use Treatment Provider Assessment of Telehealth Effectiveness for Adult and Adolescent Service Provision During the COVID-19 Pandemic.","authors":"Glenn Sterner, Michael B Lavetsky, Matthew J Ercolani, Kayla Lopez","doi":"10.1080/15504263.2025.2478893","DOIUrl":"https://doi.org/10.1080/15504263.2025.2478893","url":null,"abstract":"<p><p><b>Objective:</b> This study examined behavioral health clinician perceptions at the beginning stages of the COVID-19 pandemic regarding their preparedness, training, and effectiveness in delivering telehealth to adults and adolescents in substance use and mental health settings. <b>Methods:</b> Data were collected through an anonymous online survey of 241 behavioral health practitioners in Pennsylvania from November 17, 2020, to January 3, 2021. Quantitative descriptive and qualitative analyses on survey results are presented. <b>Results:</b> Clinicians believed they were effective in their delivery of therapeutic services through telehealth modalities. However, they noted key training needs for delivering telehealth. Results indicate greater difficulty in delivering telehealth to adolescent clients and those with substance use. Practitioners indicate that telehealth allows greater access to treatment. <b>Conclusions:</b> Researchers recommend increasing training for practitioners and conducting training for patients. Policies should be reconsidered and address the changing landscape of behavioral health service provision.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-15"},"PeriodicalIF":1.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-23DOI: 10.1080/15504263.2025.2474950
Christina E Freibott, Thisara Jayasinghe, Ellen Reagan, Daisy C Perez, Anne Berrigan, Emily Kline, Hannah E Brown, Amy M Yule
Objective: Explore local leaders' perceptions of substance use and psychosis treatment to inform the implementation of an assertive community treatment model for historically marginalized youth. Methods: Interviews were conducted with local leaders in a Northeast city with relevant expertise. Interviews were recorded, transcribed, and analyzed using the Consolidated Framework of Implementation Research domains. Results: Fifteen leaders completed interviews and four key themes emerged: (1) A patchwork of systems attempts to catch youth early on, but often fails; (2) The inability to simultaneously address mental health and substance use concerns complicates care; (3) An ideal program would be flexible in the ways the current system is inflexible; (4) factors important in tailoring a program to serve historically marginalized youth. Conclusion: When designing a program to support the engagement of youth with symptoms of psychosis and SUD, it is important to take a patient-centered and flexible approach that accounts for the community-based setting.
{"title":"Falling Through the Cracks: Perspectives From Local Leaders on Substance Use and Psychosis Treatment for Youth.","authors":"Christina E Freibott, Thisara Jayasinghe, Ellen Reagan, Daisy C Perez, Anne Berrigan, Emily Kline, Hannah E Brown, Amy M Yule","doi":"10.1080/15504263.2025.2474950","DOIUrl":"https://doi.org/10.1080/15504263.2025.2474950","url":null,"abstract":"<p><p><b>Objective:</b> Explore local leaders' perceptions of substance use and psychosis treatment to inform the implementation of an assertive community treatment model for historically marginalized youth. <b>Methods:</b> Interviews were conducted with local leaders in a Northeast city with relevant expertise. Interviews were recorded, transcribed, and analyzed using the Consolidated Framework of Implementation Research domains. <b>Results:</b> Fifteen leaders completed interviews and four key themes emerged: (1) A patchwork of systems attempts to catch youth early on, but often fails; (2) The inability to simultaneously address mental health and substance use concerns complicates care; (3) An ideal program would be flexible in the ways the current system is inflexible; (4) factors important in tailoring a program to serve historically marginalized youth. <b>Conclusion:</b> When designing a program to support the engagement of youth with symptoms of psychosis and SUD, it is important to take a patient-centered and flexible approach that accounts for the community-based setting.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-20DOI: 10.1080/15504263.2025.2478900
Signe Wegmann Düring, Ditte Maria Sivertsen, Katrine Schepelern Johansen
Objective: To examine how non-pharmacological integrated treatment components are presented in the literature, to facilitate high-quality dual diagnosis treatment and support informed decision-making in the development of integrated treatment facilities. Methods: A literature search was conducted in databases Ovid/Embase, PubMed, CINAHL focusing on intervention studies published between 2013 and 2023, describing integrated treatment for patients with dual diagnosis. A six-stage methodological framework for scoping reviews was used for selection and analysis of the papers included. Results: Twenty-six studies were included. Most integrated interventions were group therapy sessions guided by CBT or MI, however there was a large heterogeneity in the remaining core components and outcome measurements. Staff competence was often vaguely defined and described. Conclusions: The heterogeneity of the studies included influences reproductivity and comparability which makes it challenging to condense firm recommendations and point directions for design of treatment and scientific practice.
{"title":"Non-Pharmacological Components in Integrated Treatment for Patients with Dual Diagnosis: A Scoping Review.","authors":"Signe Wegmann Düring, Ditte Maria Sivertsen, Katrine Schepelern Johansen","doi":"10.1080/15504263.2025.2478900","DOIUrl":"https://doi.org/10.1080/15504263.2025.2478900","url":null,"abstract":"<p><p><b>Objective:</b> To examine how non-pharmacological integrated treatment components are presented in the literature, to facilitate high-quality dual diagnosis treatment and support informed decision-making in the development of integrated treatment facilities. <b>Methods:</b> A literature search was conducted in databases Ovid/Embase, PubMed, CINAHL focusing on intervention studies published between 2013 and 2023, describing integrated treatment for patients with dual diagnosis. A six-stage methodological framework for scoping reviews was used for selection and analysis of the papers included. <b>Results:</b> Twenty-six studies were included. Most integrated interventions were group therapy sessions guided by CBT or MI, however there was a large heterogeneity in the remaining core components and outcome measurements. Staff competence was often vaguely defined and described. <b>Conclusions</b>: The heterogeneity of the studies included influences reproductivity and comparability which makes it challenging to condense firm recommendations and point directions for design of treatment and scientific practice.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-15"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-17DOI: 10.1080/15504263.2025.2478802
Emmanuel D Thomas, Silvi C Goldstein, Jewelia J Ferguson, Diana Ho, Nicole H Weiss
Objective: Drug use and related harm among women of color who experience intimate partner violence (IPV) is a serious clinical concern. Depression symptoms have been identified as an important risk factor for the development of drug use and related harm among women of color with a history of IPV. The current study advances this research by examining the roles of distinct domains of racial microaggressions in the relation between depression symptoms and drug use and related harm in this population. Method: Participants were 103 women of color experiencing IPV (Mage = 40.39, 51% Black/African American). Results: Results indicated an indirect effect of depression symptoms on drug use and related harm via racial microaggression domains of Assumptions of Inferiority, Second-Class Citizen and Assumptions of Criminality, Microinvalidations, Exoticization and Assumptions of Similarity, and Environmental Microaggressions. Conclusions: Findings provide preliminary support for the role of racial microaggressions in the association between depression and drug use and related harm among women of color experiencing IPV.
{"title":"Exploring the Role of Racial Microaggressions in the Association Between Depression Symptoms and Drug Use and Related Harm Among Women of Color Experiencing Intimate Partner Violence.","authors":"Emmanuel D Thomas, Silvi C Goldstein, Jewelia J Ferguson, Diana Ho, Nicole H Weiss","doi":"10.1080/15504263.2025.2478802","DOIUrl":"https://doi.org/10.1080/15504263.2025.2478802","url":null,"abstract":"<p><p><b>Objective:</b> Drug use and related harm among women of color who experience intimate partner violence (IPV) is a serious clinical concern. Depression symptoms have been identified as an important risk factor for the development of drug use and related harm among women of color with a history of IPV. The current study advances this research by examining the roles of distinct domains of racial microaggressions in the relation between depression symptoms and drug use and related harm in this population. <b>Method:</b> Participants were 103 women of color experiencing IPV (<i>M</i><sub>age</sub> = 40.39, 51% Black/African American). <b>Results:</b> Results indicated an indirect effect of depression symptoms on drug use and related harm via racial microaggression domains of Assumptions of Inferiority, Second-Class Citizen and Assumptions of Criminality, Microinvalidations, Exoticization and Assumptions of Similarity, and Environmental Microaggressions. <b>Conclusions:</b> Findings provide preliminary support for the role of racial microaggressions in the association between depression and drug use and related harm among women of color experiencing IPV.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-14DOI: 10.1080/15504263.2025.2478897
Cynthia Ramasubbu, Sukhpreet Poonia, Erin Brady-Randle, Christian G Schutz, Reza Rafizadeh
Objective: Co-occurrence of schizophrenia/schizoaffective disorder (SSD) and stimulant use disorder (StUD) is an ongoing clinical problem and can lead to poor outcomes. Although emerging evidence has suggested psychostimulant substitution therapy may result in improved outcomes in those with StUD, the efficacy and safety of psychostimulant substitution therapy for StUD in those with concurrent SSD is uncertain. This review aims to systematically find and assess all available efficacy and safety evidence on the use of prescription psychostimulants in those with co-occurring SSD and StUD. Methods: Electronic searches of MEDLINE, PsycINFO, Embase, Scopus, ClinicalTrials, EU Clinical Trials, and CADTH were conducted from inception to February 27, 2024. Any study design was accepted if they involved the following concepts 1) SSD and StUD and 2) prescription psychostimulants. Given the paucity of trials meeting criteria, outcomes of interest were described qualitatively. Risk of bias was assessed using Q-Coh and ROB2. Results: Only seven articles met criteria, and most of these were case reports and series. The single RCT included was at high risk of bias. Outcomes included abstinence, reductions in non-prescribed stimulant use, psychiatric hospitalizations, levels of craving, improvements in mental health, improvements in psychosocial functioning, adherence to antipsychotic medications, and retention in treatment. Most of the results indicated that psychostimulant substitution therapy in individuals with SSD-StUD was not associated with improved outcomes. Conclusion: Available evidence for treatment of StUD via psychostimulant substitution therapy in individuals with SSD is lacking. More exploration is required for this clinical question to allow for current practice to be backed by evidence.
{"title":"Psychostimulant Substitution Therapy for the Treatment of Stimulant Use Disorders in Patients with Schizophrenia or Schizoaffective Disorder: A Systematic Review.","authors":"Cynthia Ramasubbu, Sukhpreet Poonia, Erin Brady-Randle, Christian G Schutz, Reza Rafizadeh","doi":"10.1080/15504263.2025.2478897","DOIUrl":"https://doi.org/10.1080/15504263.2025.2478897","url":null,"abstract":"<p><p><b>Objective:</b> Co-occurrence of schizophrenia/schizoaffective disorder (SSD) and stimulant use disorder (StUD) is an ongoing clinical problem and can lead to poor outcomes. Although emerging evidence has suggested psychostimulant substitution therapy may result in improved outcomes in those with StUD, the efficacy and safety of psychostimulant substitution therapy for StUD in those with concurrent SSD is uncertain. This review aims to systematically find and assess all available efficacy and safety evidence on the use of prescription psychostimulants in those with co-occurring SSD and StUD. <b>Methods:</b> Electronic searches of MEDLINE, PsycINFO, Embase, Scopus, ClinicalTrials, EU Clinical Trials, and CADTH were conducted from inception to February 27, 2024. Any study design was accepted if they involved the following concepts 1) SSD and StUD and 2) prescription psychostimulants. Given the paucity of trials meeting criteria, outcomes of interest were described qualitatively. Risk of bias was assessed using Q-Coh and ROB2. <b>Results:</b> Only seven articles met criteria, and most of these were case reports and series. The single RCT included was at high risk of bias. Outcomes included abstinence, reductions in non-prescribed stimulant use, psychiatric hospitalizations, levels of craving, improvements in mental health, improvements in psychosocial functioning, adherence to antipsychotic medications, and retention in treatment. Most of the results indicated that psychostimulant substitution therapy in individuals with SSD-StUD was not associated with improved outcomes. <b>Conclusion:</b> Available evidence for treatment of StUD via psychostimulant substitution therapy in individuals with SSD is lacking. More exploration is required for this clinical question to allow for current practice to be backed by evidence.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-12-01DOI: 10.1080/15504263.2024.2433768
Julia Thomas, Jennifer Carrano, Rebecca L Schacht, Marc Fishman, Kevin Wenzel
Objective: Adverse Childhood Events (ACEs) are associated with increased vulnerability for posttraumatic stress disorder (PTSD), but not everyone who experiences ACEs develops PTSD. Impulsivity has gained interest as a potential mediator between ACEs and PTSD, given that both PTSD and ACEs have been closely related to impulsivity. However, less is known about the relationship within the context of substance use disorder (SUD), a population highly vulnerable to co-occurring PTSD. This study examined whether impulsivity mediates the relationship between ACEs and PTSD symptoms in adults seeking residential treatment for substance use disorder (SUD). Methods:N = 134 consenting adults in residential treatment for SUD completed questionnaires measuring impulsivity (UPPS-P), ACEs (ACEs Scale), and PTSD symptoms (PCL-5). Regression models tested our hypotheses that ACEs would predict PTSD symptoms and that impulsivity would mediate this relationship. Results: Two-thirds of participants met the PCL-5 score threshold for a provisional diagnosis of PTSD. ACEs score and impulsivity were significant direct predictors of PTSD symptoms (coeff = 2.23, p < .001; coeff = 1.03, p < .001). Among UPPS-P subconstructs, only lack of premeditation emerged as a partial mediator (z = 2.14, p = 0.032). Conclusions: Individuals with SUD experience adverse and traumatic events at alarming rates and are at increased risk for PTSD. Our mediation finding suggests that impulsivity and especially lack of premeditation may be clinically relevant in the development or maintenance of PTSD symptoms among individuals with SUD.
目的:童年不良事件(ace)与创伤后应激障碍(PTSD)的易损性增加有关,但并非所有经历过ace的人都会患上PTSD。鉴于创伤后应激障碍和ace都与冲动性密切相关,冲动性作为ace和PTSD之间的潜在中介已引起人们的兴趣。然而,在物质使用障碍(SUD)的背景下,人们对这种关系知之甚少,这是一个极易发生PTSD的人群。本研究探讨冲动性是否在寻求物质使用障碍(SUD)住院治疗的成人的ace和PTSD症状之间起中介作用。方法:N = 134名自愿接受SUD住院治疗的成年人完成了冲动性(UPPS-P)、ace (ace量表)和PTSD症状(PCL-5)的问卷调查。回归模型检验了我们的假设,即ace可以预测PTSD症状,冲动可以调节这种关系。结果:三分之二的参与者达到了临时诊断PTSD的PCL-5评分阈值。ace评分和冲动性是PTSD症状的显著直接预测因子(coeff = 2.23, p < 0.001;Coeff = 1.03, p < .001)。在UPPS-P亚构中,只有缺乏预谋是部分中介(z = 2.14, p = 0.032)。结论:患有SUD的个体经历不良和创伤性事件的比率惊人,并且患PTSD的风险增加。我们的调解发现表明,冲动,特别是缺乏预谋可能在临床上与患有SUD的个体的PTSD症状的发展或维持有关。
{"title":"Lack of Premeditation Mediates the Relationship Between Adverse Childhood Experiences and Posttraumatic Stress Disorder in Individuals in Residential Treatment for Substance Use Disorder.","authors":"Julia Thomas, Jennifer Carrano, Rebecca L Schacht, Marc Fishman, Kevin Wenzel","doi":"10.1080/15504263.2024.2433768","DOIUrl":"10.1080/15504263.2024.2433768","url":null,"abstract":"<p><p><b>Objective:</b> Adverse Childhood Events (ACEs) are associated with increased vulnerability for posttraumatic stress disorder (PTSD), but not everyone who experiences ACEs develops PTSD. Impulsivity has gained interest as a potential mediator between ACEs and PTSD, given that both PTSD and ACEs have been closely related to impulsivity. However, less is known about the relationship within the context of substance use disorder (SUD), a population highly vulnerable to co-occurring PTSD. This study examined whether impulsivity mediates the relationship between ACEs and PTSD symptoms in adults seeking residential treatment for substance use disorder (SUD). <b>Methods:</b> <i>N</i> = 134 consenting adults in residential treatment for SUD completed questionnaires measuring impulsivity (UPPS-P), ACEs (ACEs Scale), and PTSD symptoms (PCL-5). Regression models tested our hypotheses that ACEs would predict PTSD symptoms and that impulsivity would mediate this relationship. <b>Results:</b> Two-thirds of participants met the PCL-5 score threshold for a provisional diagnosis of PTSD. ACEs score and impulsivity were significant direct predictors of PTSD symptoms (coeff = 2.23, <i>p</i> < .001; coeff = 1.03, <i>p</i> < .001). Among UPPS-P subconstructs, only lack of premeditation emerged as a partial mediator (z = 2.14, <i>p</i> = 0.032). <b>Conclusions:</b> Individuals with SUD experience adverse and traumatic events at alarming rates and are at increased risk for PTSD. Our mediation finding suggests that impulsivity and especially lack of premeditation may be clinically relevant in the development or maintenance of PTSD symptoms among individuals with SUD.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"3-12"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-11-28DOI: 10.1080/15504263.2024.2434740
Abel Rubega, Moses Muwanguzi, Rahel Nkola, Alain Favina, Joseph Kirabira, Samuel Maling, Scholastic Ashaba
Objective: Substance use is common among people with primary mental illness especially schizophrenia and bipolar disorder compared to the general population and complicates treatment outcomes. Methods: We enrolled 385 patients with primary mental illnesses in southwestern Uganda between June and August 2022. We collected information on alcohol and cannabis use, social support, religiosity, adherence to treatment and sociodemographic characteristics. We run a logistic regression model to determine the factors associated with substance use disorder. Results: At multivariable analysis, being male (AOR = 13.61, 95% CI [3.66-50.63]: p <.001) and prior history of cannabis/alcohol use (AOR = 34.95, 95% CI [8.80-138.72]: p < .001) were significantly associated with substance use disorder while adherence to treatment was against substance use disorder (AOR = 0.27, 95% CI [0.09-0.83]: p = .03). Conclusions: Adherence to treatment is protective against substance use disorder among people with mental illness. Interventions aiming at preventing substance use disorder among people with mental illness should aim at promoting adherence to treatment.
目的:与普通人群相比,药物滥用在原发性精神疾病患者(尤其是精神分裂症和躁郁症患者)中很常见,并使治疗效果变得复杂。研究方法我们于 2022 年 6 月至 8 月间在乌干达西南部招募了 385 名原发性精神病患者。我们收集了有关酒精和大麻使用、社会支持、宗教信仰、坚持治疗和社会人口特征的信息。我们采用逻辑回归模型来确定与药物使用障碍相关的因素。结果如下在多变量分析中,男性(AOR = 13.61,95% CI [3.66-50.63]:P .001)和既往大麻/酒精使用史(AOR = 34.95,95% CI [8.80-138.72]:P .001)与药物使用障碍显著相关,而坚持治疗与药物使用障碍相对(AOR = 0.27,95% CI [0.09-0.83]:P = .03)。结论坚持治疗可以防止精神疾病患者出现药物使用障碍。旨在预防精神疾病患者药物使用障碍的干预措施应以促进坚持治疗为目标。
{"title":"Substance Use Disorder Among Patients with Primary Mental Illnesses in Southwestern Uganda.","authors":"Abel Rubega, Moses Muwanguzi, Rahel Nkola, Alain Favina, Joseph Kirabira, Samuel Maling, Scholastic Ashaba","doi":"10.1080/15504263.2024.2434740","DOIUrl":"10.1080/15504263.2024.2434740","url":null,"abstract":"<p><p><b>Objective</b>: Substance use is common among people with primary mental illness especially schizophrenia and bipolar disorder compared to the general population and complicates treatment outcomes. <b>Methods:</b> We enrolled 385 patients with primary mental illnesses in southwestern Uganda between June and August 2022. We collected information on alcohol and cannabis use, social support, religiosity, adherence to treatment and sociodemographic characteristics. We run a logistic regression model to determine the factors associated with substance use disorder. <b>Results:</b> At multivariable analysis, being male (AOR = 13.61, 95% CI [3.66-50.63]: <i>p <</i>.001) and prior history of cannabis/alcohol use (AOR = 34.95, 95% CI [8.80-138.72]: <i>p <</i> .001) were significantly associated with substance use disorder while adherence to treatment was against substance use disorder (AOR = 0.27, 95% CI [0.09-0.83]: <i>p =</i> .03). <b>Conclusions:</b> Adherence to treatment is protective against substance use disorder among people with mental illness. Interventions aiming at preventing substance use disorder among people with mental illness should aim at promoting adherence to treatment.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"13-23"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-11DOI: 10.1080/15504263.2024.2434218
Margarida Bastos Maia, Pedro Miguel Martins, Margarida Figueiredo-Braga
Objective: Motivational interviewing (MI) is a client centered counseling approach which aims to promote behavior change by enhancing patient motivation through the exploration and resolution of ambivalence. This type of psychotherapy, initially designed for the treatment of substance use disorders (SUD), is now seen as an effective way to manage chronic physical and psychiatric diseases. Patients with Dual Diagnosis (DD), people who simultaneously have a SUD diagnosis and a mental illness, are a complex group of psychiatric patients who have a particularly low treatment engagement. It was hypothesized that MI could be a valuable add-on therapy for DD patients. This review summarizes the main findings of randomized controlled trials applying MI to patients' psychiatric diagnoses and substance use. We aim to clarify previous inconsistent results regarding MI effectivity in this complex and challenging disorder.
Method: The systematic literature search of PubMed/MEDLINE, Web Of Science and Scopus followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The final selection for this systematic review comprised exclusively of randomized controlled trials (RCTs) comparing MI alone or integrated into routine care. All patients included in the selected studies were over 16 years old. The studies' quality assessment was conducted with the Jadad Scale.
Results: 8 RCTs were included in this review. The patients who underwent MI interventions showed an improvement in functioning, psychiatric symptoms, medication compliance and substance use, although without statistical significance. The number of relapses, total days in relapse and alcohol binge days showed a significant improvement in favor of the intervention group (p = .002, Bellack et al., 2006; p = .006, Haddock et al., 2003; and p = .02).
Conclusions: Although there was a clear improvement in most of these outcomes, most studies failed to detect significant results. A significant clinical outcome of MI application was found in lower relapse occurrence and alcohol abuse. The disparity of findings may be due to the disorder's heterogeneity, and/or to methodological limitations. Our results emphasize the need for more methodically sound RCTs with adaptable characteristics specific to the pairing of psychiatric disease and substance abuse.
目的:动机性访谈(MI)是一种以来访者为中心的心理咨询方法,旨在通过探索和解决矛盾心理,增强患者的动机,从而促进行为改变。这种类型的心理治疗最初是为治疗物质使用障碍(SUD)而设计的,现在被视为治疗慢性身体和精神疾病的有效方法。双重诊断(DD)患者,即同时患有SUD诊断和精神疾病的人,是一群复杂的精神病患者,他们的治疗参与度特别低。假设心肌梗死可能是DD患者的一种有价值的附加治疗。本文综述了将心肌梗死应用于患者精神诊断和药物使用的随机对照试验的主要发现。我们的目的是澄清先前关于心肌梗死在这种复杂和具有挑战性的疾病中的有效性的不一致的结果。方法:按照PRISMA (Preferred Reporting Items for systematic Reviews and Meta-Analysis)指南,对PubMed/MEDLINE、Web of Science和Scopus进行系统文献检索。本系统评价的最终选择仅包括比较单独心肌梗死或合并常规护理的随机对照试验(rct)。入选研究的所有患者年龄均在16岁以上。采用Jadad量表进行研究质量评价。结果:本综述纳入8项rct。接受心肌梗死干预的患者在功能、精神症状、药物依从性和物质使用方面均有改善,但无统计学意义。干预组在复吸次数、复吸总天数和酗酒天数方面均有显著改善(p = 0.002, Bellack et al., 2006;p = 0.006, Haddock et al., 2003;p = .02)。结论:虽然这些结果大多数有明显的改善,但大多数研究未能发现显著的结果。应用心肌梗死的显著临床结果是复发率和酒精滥用率较低。结果的差异可能是由于疾病的异质性,和/或方法的局限性。我们的研究结果强调需要更有条理的可靠的随机对照试验,具有特定于精神疾病和药物滥用配对的适应性特征。
{"title":"Outcomes and Challenges of Motivational Interviewing in Dual Diagnosis Treatment-A Systematic Review.","authors":"Margarida Bastos Maia, Pedro Miguel Martins, Margarida Figueiredo-Braga","doi":"10.1080/15504263.2024.2434218","DOIUrl":"10.1080/15504263.2024.2434218","url":null,"abstract":"<p><strong>Objective: </strong>Motivational interviewing (MI) is a client centered counseling approach which aims to promote behavior change by enhancing patient motivation through the exploration and resolution of ambivalence. This type of psychotherapy, initially designed for the treatment of substance use disorders (SUD), is now seen as an effective way to manage chronic physical and psychiatric diseases. Patients with Dual Diagnosis (DD), people who simultaneously have a SUD diagnosis and a mental illness, are a complex group of psychiatric patients who have a particularly low treatment engagement. It was hypothesized that MI could be a valuable add-on therapy for DD patients. This review summarizes the main findings of randomized controlled trials applying MI to patients' psychiatric diagnoses and substance use. We aim to clarify previous inconsistent results regarding MI effectivity in this complex and challenging disorder.</p><p><strong>Method: </strong>The systematic literature search of PubMed/MEDLINE, Web Of Science and Scopus followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The final selection for this systematic review comprised exclusively of randomized controlled trials (RCTs) comparing MI alone or integrated into routine care. All patients included in the selected studies were over 16 years old. The studies' quality assessment was conducted with the Jadad Scale.</p><p><strong>Results: </strong>8 RCTs were included in this review. The patients who underwent MI interventions showed an improvement in functioning, psychiatric symptoms, medication compliance and substance use, although without statistical significance. The number of relapses, total days in relapse and alcohol binge days showed a significant improvement in favor of the intervention group (<i>p =</i> .002, Bellack et al., 2006; <i>p =</i> .006, Haddock et al., 2003; and <i>p =</i> .02).</p><p><strong>Conclusions: </strong>Although there was a clear improvement in most of these outcomes, most studies failed to detect significant results. A significant clinical outcome of MI application was found in lower relapse occurrence and alcohol abuse. The disparity of findings may be due to the disorder's heterogeneity, and/or to methodological limitations. Our results emphasize the need for more methodically sound RCTs with adaptable characteristics specific to the pairing of psychiatric disease and substance abuse.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"56-69"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-12-10DOI: 10.1080/15504263.2024.2435544
Breanne Hobden, Jia Ying-Ooi, Jamie Bryant, Jennifer Rumbel, Todd Heard, Robert Davis, Bron Rose, Megan Freund
Objective: This systematic review describes studies focussed on co-occurring mental health and substance use (MH/SU) conditions among Aboriginal and Torres Strait Islander people, including the: characteristics; co-occurring conditions examined; cultural methodological quality; traditional scientific methodological quality of studies; and study outcomes. Methods: A systematic review examined the literature on co-occurring MH/SU conditions among Aboriginal and Torres Strait Islander people. Four databases were searched, with data from relevant studies extracted for narrative synthesis. Results: Twelve articles (11 studies) were included. Nine studies used cross-sectional designs; one was a qualitative study and one a mixed methods study with a nested randomized controlled trial. Cultural methodological quality was low across the studies, with a maximum of 7 out of 14 criteria met. Thirty-three combinations of co-occurring conditions were examined. Conclusion: Most research to date has been cross-sectional with limited research exploring the effectiveness of treatments for co-occurring MH/SU conditions. Further Indigenous-led research is needed to find culturally safe, responsive and effective solutions in reducing the burden associated with MH/SU conditions and improving wellbeing.
{"title":"Co-Occurring Mental Health and Substance Use Research Among Aboriginal and Torres Strait Islander People: A Systematic Review.","authors":"Breanne Hobden, Jia Ying-Ooi, Jamie Bryant, Jennifer Rumbel, Todd Heard, Robert Davis, Bron Rose, Megan Freund","doi":"10.1080/15504263.2024.2435544","DOIUrl":"10.1080/15504263.2024.2435544","url":null,"abstract":"<p><p><b>Objective:</b> This systematic review describes studies focussed on co-occurring mental health and substance use (MH/SU) conditions among Aboriginal and Torres Strait Islander people, including the: characteristics; co-occurring conditions examined; cultural methodological quality; traditional scientific methodological quality of studies; and study outcomes. <b>Methods:</b> A systematic review examined the literature on co-occurring MH/SU conditions among Aboriginal and Torres Strait Islander people. Four databases were searched, with data from relevant studies extracted for narrative synthesis. <b>Results:</b> Twelve articles (11 studies) were included. Nine studies used cross-sectional designs; one was a qualitative study and one a mixed methods study with a nested randomized controlled trial. Cultural methodological quality was low across the studies, with a maximum of 7 out of 14 criteria met. Thirty-three combinations of co-occurring conditions were examined. <b>Conclusion:</b> Most research to date has been cross-sectional with limited research exploring the effectiveness of treatments for co-occurring MH/SU conditions. Further Indigenous-led research is needed to find culturally safe, responsive and effective solutions in reducing the burden associated with MH/SU conditions and improving wellbeing.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"70-86"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}