Mental health and substance use : dual diagnosis最新文献

BACKGROUND: Persons with mental disorders frequently have other co-occurring problems such as substance related disorders and HIV/AIDS. Individuals with co-occurring medical and mental disorders encounter great obstacles to receiving mental health services. AIMS: This paper uses the Behavioral Model of Vulnerable Populations to evaluate use of mental health services among groups with co-occurring disorders (CODs) and other co-morbid relationships. The association between receipt of mental health treatment and traditional/vulnerable predisposing, enabling, and need factors are examined. METHODS: Bivariate analysis and two-stage hierarchical logistic regression were completed. RESUTLS: A sample of 553 persons who reported mental health problems within the past year had one or more of the following vulnerabilities: (1) substance disorders; (2) homelessness; (3) victims of violent crime; (4) diagnosed with HIV/AIDS; (5) recipient of public benefits; and 31.3% reported having received some form of mental health treatment. Both traditional and vulnerable characteristics are significant predictors of receipt of mental health treatment. Vulnerable predictors indicated decreased odds of receiving mental health treatment were associated with injection and chronic drug use, (OR = .42, CI: .22 - .77) and (OR = .38, CI: .22 - .64) respectively. CONCLUSION: The Behavioral Model of Vulnerable Populations could be employed in future research of CODs and other co-morbid group's utilization of mental health treatment.

INTRODUCTION: Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) are each associated with profound disruptions in psychological, social, and physical functioning, and these disruptions are compounded in individuals with both disorders. Comorbidity between the two disorders is high, with the risk for AD increasing substantially among individuals with PTSD and, conversely, PTSD is highly prevalent among people experiencing AD. AIMS: Given the increased impairment associated with this comorbidity, it is imperative to develop effective treatments for individuals who experience both disorders. METHODS: This paper describes the methodology of a study that examines the efficacy of prolonged exposure therapy alone, naltrexone alone, and their combination compared to pill placebo in reducing the severity of PTSD and alcohol use in individuals with comorbid AD and PTSD. DISCUSSION: Issues related to design, assessment, treatment choice, and challenges posed by the study population are discussed.

BACKGROUND: Research has reported a high rate of substance dependence in traumatized individuals who do not develop PTSD (TWP). While past studies have failed to consistently demonstrate that TWP individuals experience PTSD symptoms, findings have indicated that TWP and a history of substance dependence aside from nicotine dependence (SDH) are linked to affect disruption. AIMS: The present study explored positive and negative affective mechanisms across four groups with varying SDH and TWP including TWP + SDH, TWP only, SDH only, or no history. Researchers hypothesized that adults (n = 78) would be more emotionally reactive to an experimentally-induced negative mood compared to a neutral mood induction as the presence of co-existing TWP and SDH increased. METHOD: After a brief telephone screening, eligible participants completed baseline self-report questionnaires and experimentally-manipulated negative and neutral mood inductions. RESULTS: Most notably, results showed a significant TWP x SDH x Mood induction interaction (F (1, 63) = 4.154; Mse = 51.999; p = .046) for positive affect responses. Simple effects indicated that all participants except TWP + SDH individuals experienced a significant decrease in positive affect during the negative compared to the neutral mood condition. CONCLUSION: Findings may identify a protective mechanism for relapse among individuals with a history of both TWP and SDH.