Pub Date : 2009-09-18DOI: 10.1080/17523280903155307
Thomas M. Dunn, V. Collins, R. House, P. Weintraub
We present the case of a 55-year-old homeless male who presented with penis and scrotal maggot infestation secondary to genital self-mutilation. The patient gave a history consistent with gender identity disorder and indicated that he was intoxicated during the event. The patient had no history of psychosis. He sought medical attention only after he was no longer welcome on public transportation due to the odor emanating from this infection. Untreated gender identity disorder with alcohol dependence in this case led to a drastic behavior with significant consequences.
{"title":"Male genital self-mutilation with maggot infestation in an intoxicated individual","authors":"Thomas M. Dunn, V. Collins, R. House, P. Weintraub","doi":"10.1080/17523280903155307","DOIUrl":"https://doi.org/10.1080/17523280903155307","url":null,"abstract":"We present the case of a 55-year-old homeless male who presented with penis and scrotal maggot infestation secondary to genital self-mutilation. The patient gave a history consistent with gender identity disorder and indicated that he was intoxicated during the event. The patient had no history of psychosis. He sought medical attention only after he was no longer welcome on public transportation due to the odor emanating from this infection. Untreated gender identity disorder with alcohol dependence in this case led to a drastic behavior with significant consequences.","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"65 1","pages":"235-238"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89859201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903154961
J. Talmet, De Crespigny, L. Cusack, P. Athanasos
Background: Australians seeking health care from any public hospital have the right to non-discriminatory safe medical assessment, treatment and nursing care. The literature clearly indicates that people presenting to public hospitals with acute alcohol- or drug-related conditions are at risk of dying by being denied medical and nursing treatment. This denial of treatment is on the basis that their presumed condition is solely drug- and alcohol-related. There is often even a greater risk for Aboriginal people who present for treatment. This literature comprises reports from coronial inquiries, police incidents, safety audits, and critical incidents in health services, and anecdotal information from specialist drug and alcohol nurses. Such violation of this vulnerable population's right to safe health care has often resulted in suicide and other preventable deaths, disability and exacerbation of physical and mental illness. Method: A critique was conducted of recent available Australian ‘grey’ literature c...
{"title":"‘Turning a blind eye’: denying people their right to treatment for acute alcohol, drug and mental health conditions – an act of discrimination","authors":"J. Talmet, De Crespigny, L. Cusack, P. Athanasos","doi":"10.1080/17523280903154961","DOIUrl":"https://doi.org/10.1080/17523280903154961","url":null,"abstract":"Background: Australians seeking health care from any public hospital have the right to non-discriminatory safe medical assessment, treatment and nursing care. The literature clearly indicates that people presenting to public hospitals with acute alcohol- or drug-related conditions are at risk of dying by being denied medical and nursing treatment. This denial of treatment is on the basis that their presumed condition is solely drug- and alcohol-related. There is often even a greater risk for Aboriginal people who present for treatment. This literature comprises reports from coronial inquiries, police incidents, safety audits, and critical incidents in health services, and anecdotal information from specialist drug and alcohol nurses. Such violation of this vulnerable population's right to safe health care has often resulted in suicide and other preventable deaths, disability and exacerbation of physical and mental illness. Method: A critique was conducted of recent available Australian ‘grey’ literature c...","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"25 1","pages":"247-254"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87283516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903204337
A. Oyefeso, C. Clancy
There is evidence of the occurrence of executive dysfunction (ED) and Attention Deficit Hyperactivity Disorder (ADHD) among opiate dependents. However, the nature of this relationship and its impact on treatment outcome in this population has not been sufficiently examined. This article speculates on the individual and combined influence of ED and ADHD on treatment response among opiate dependents, examines the implications of these associations for developing novel interventions, and suggests associated workforce development and research priorities.
{"title":"Comorbidity of executive dysfunction, ADHD and opiate dependence: implication for treatment improvement","authors":"A. Oyefeso, C. Clancy","doi":"10.1080/17523280903204337","DOIUrl":"https://doi.org/10.1080/17523280903204337","url":null,"abstract":"There is evidence of the occurrence of executive dysfunction (ED) and Attention Deficit Hyperactivity Disorder (ADHD) among opiate dependents. However, the nature of this relationship and its impact on treatment outcome in this population has not been sufficiently examined. This article speculates on the individual and combined influence of ED and ADHD on treatment response among opiate dependents, examines the implications of these associations for developing novel interventions, and suggests associated workforce development and research priorities.","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"49 1","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75376954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903155281
N. Díaz, G. Horton, J. Mcilveen, Michael Weiner, Donald Mullaney
Background: Limited research has been conducted exploring the mental health problems experienced by flight attendants, even though they are asked to respond and cope with stressful situations that place them under a great deal of stress and emotional vulnerability. Aims: The aim of this study was to explore the prevalence of dysthymia, and its comorbid relationship with other mental health and substance use disorders among flight attendants attending residential substance abuse treatment. Methods: Seventy medical charts of flight attendants admitted consecutively to a residential substance abuse treatment agency were reviewed. Data collected included information concerning multiple Axes I and II disorders; sociodemographic characteristics; number of previous mental health and substance abuse treatments; number of times of attempted suicide and the number of suicide attempts under the influence of alcohol or drugs; and perceived quality of life. Results: Findings indicated that over half the sample reporte...
{"title":"Comorbidity among dysthymia, substance use, and other mental health disorders: characteristics of flight attendants in residential substance abuse treatment in the United States","authors":"N. Díaz, G. Horton, J. Mcilveen, Michael Weiner, Donald Mullaney","doi":"10.1080/17523280903155281","DOIUrl":"https://doi.org/10.1080/17523280903155281","url":null,"abstract":"Background: Limited research has been conducted exploring the mental health problems experienced by flight attendants, even though they are asked to respond and cope with stressful situations that place them under a great deal of stress and emotional vulnerability. Aims: The aim of this study was to explore the prevalence of dysthymia, and its comorbid relationship with other mental health and substance use disorders among flight attendants attending residential substance abuse treatment. Methods: Seventy medical charts of flight attendants admitted consecutively to a residential substance abuse treatment agency were reviewed. Data collected included information concerning multiple Axes I and II disorders; sociodemographic characteristics; number of previous mental health and substance abuse treatments; number of times of attempted suicide and the number of suicide attempts under the influence of alcohol or drugs; and perceived quality of life. Results: Findings indicated that over half the sample reporte...","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"33 1","pages":"212-225"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85729125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903200194
A. Baker, R. Velleman
Background: There is a high prevalence of co-existing mental health and drug and alcohol problems. Many people with these co-existing problems initially present in a range of contexts including the criminal justice system and social care settings relating to housing, relationships, family problems, etc., as opposed to mental health or substance misuse services. A complicating factor is that many people with these co-existing problems do not recognise that they have such problems and do not ask for help. This paper seeks to help workers within such agencies to detect co-existing mental health and drug and alcohol problems, in order to offer help directly or to enable an onward referral. Method: A search of the published English language literature with a focus on screening instruments for mental health and drug and alcohol use problems was performed. Screening instruments were selected which: have some evidence supporting reliability and/or validity when used with people with co-existing problems or in non...
{"title":"Helping non-specialist professionals to detect and assist with co-existing mental health and drug and alcohol problems","authors":"A. Baker, R. Velleman","doi":"10.1080/17523280903200194","DOIUrl":"https://doi.org/10.1080/17523280903200194","url":null,"abstract":"Background: There is a high prevalence of co-existing mental health and drug and alcohol problems. Many people with these co-existing problems initially present in a range of contexts including the criminal justice system and social care settings relating to housing, relationships, family problems, etc., as opposed to mental health or substance misuse services. A complicating factor is that many people with these co-existing problems do not recognise that they have such problems and do not ask for help. This paper seeks to help workers within such agencies to detect co-existing mental health and drug and alcohol problems, in order to offer help directly or to enable an onward referral. Method: A search of the published English language literature with a focus on screening instruments for mental health and drug and alcohol use problems was performed. Screening instruments were selected which: have some evidence supporting reliability and/or validity when used with people with co-existing problems or in non...","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"7 1","pages":"173-181"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79174514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903192003
M. Hesse, S. Austin, J. Lykke, I. Oestrich
Background: Little is known about predictors of successful inpatient treatment of dual diagnosis patients. Methods: In a naturalistic prospective study, consecutive patients admitted to a dual diagnosis inpatient cognitive milieu therapy program were evaluated at intake to treatment with the Brief Psychiatric Rating Scale (BPRS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Severity of Dependence Scale (SDS). Logistic regression was used to determine predictors of confirmed abstinence during community linkage and completing treatment with medical advice. Results: No significant predictors were found of completing treatment. High thought disturbance, anxiety and severity of dependence were associated with drug or alcohol use during community linkage. A diagnosis of alcohol dependence was associated with abstinence during community linkage. Discussion: Dual diagnosis patients with severe substance dependence, as well as patients with elevated thought disturbance and anxiety...
{"title":"Predictors of completing treatment and achieving abstinence during inpatient dual diagnosis treatment","authors":"M. Hesse, S. Austin, J. Lykke, I. Oestrich","doi":"10.1080/17523280903192003","DOIUrl":"https://doi.org/10.1080/17523280903192003","url":null,"abstract":"Background: Little is known about predictors of successful inpatient treatment of dual diagnosis patients. Methods: In a naturalistic prospective study, consecutive patients admitted to a dual diagnosis inpatient cognitive milieu therapy program were evaluated at intake to treatment with the Brief Psychiatric Rating Scale (BPRS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Severity of Dependence Scale (SDS). Logistic regression was used to determine predictors of confirmed abstinence during community linkage and completing treatment with medical advice. Results: No significant predictors were found of completing treatment. High thought disturbance, anxiety and severity of dependence were associated with drug or alcohol use during community linkage. A diagnosis of alcohol dependence was associated with abstinence during community linkage. Discussion: Dual diagnosis patients with severe substance dependence, as well as patients with elevated thought disturbance and anxiety...","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"81 1","pages":"182-190"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78021943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903200210
E. Whicher, M. Abou-Saleh
Background: Comorbid severe mental illness and substance misuse occur in 15% of patients attending community mental health teams. Although these patients have poorer outcomes than those without comorbidity, historically they have been inadequately provided for by existing addiction and mental health services. Development: In Richmond, UK, a new service was developed for people with dual diagnosis without extra staffing or financial resources. The model comprised three components: a link worker from the community drug and alcohol team who works with individual mental health teams to offer advice and attend multidisciplinary meetings; a five-day training in dual diagnosis for staff; and a protocol for joint working of patients by both mental health and substance misuse teams. Discussion: The major issue in implementing the model was engaging staff, but overall referral pathways between teams have improved. In addition, the majority of dual diagnosis patients attend joint appointments, and 80 members of staf...
{"title":"Developing a service for people with dual diagnosis","authors":"E. Whicher, M. Abou-Saleh","doi":"10.1080/17523280903200210","DOIUrl":"https://doi.org/10.1080/17523280903200210","url":null,"abstract":"Background: Comorbid severe mental illness and substance misuse occur in 15% of patients attending community mental health teams. Although these patients have poorer outcomes than those without comorbidity, historically they have been inadequately provided for by existing addiction and mental health services. Development: In Richmond, UK, a new service was developed for people with dual diagnosis without extra staffing or financial resources. The model comprised three components: a link worker from the community drug and alcohol team who works with individual mental health teams to offer advice and attend multidisciplinary meetings; a five-day training in dual diagnosis for staff; and a protocol for joint working of patients by both mental health and substance misuse teams. Discussion: The major issue in implementing the model was engaging staff, but overall referral pathways between teams have improved. In addition, the majority of dual diagnosis patients attend joint appointments, and 80 members of staf...","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"34 1","pages":"226-234"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87151637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903155562
A. Bartu
{"title":"Are the terms dual diagnosis and comorbidity redundant","authors":"A. Bartu","doi":"10.1080/17523280903155562","DOIUrl":"https://doi.org/10.1080/17523280903155562","url":null,"abstract":"","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"40 1","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79592098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-09-18DOI: 10.1080/17523280903156073
M. Brunette, R. Dawson, C. O'Keefe, P. Buckley, A. Green
Background: Preliminary studies suggest that quetiapine, a mixed dopaminergic and serotonergic agent used for the treatment of psychosis, may decrease substance use in patients with schizophrenia. Method: A three-month, uncontrolled, open-label prospective study of 23 outpatients with schizophrenia or schizoaffective disorder and co-occurring alcohol use disorder was conducted at two sites. Due to substantial site differences, outcomes are reported separately for each site on the 16 study subjects who completed at least one month of quetiapine treatment (mean dose 472 ± 255 mg). Results: At Site 1 (n = 11), mean days of drinking each week decreased, but not significantly (3.18 ± 1.63 to 2.71 ± 2.32, t = 1.2, df = 10, p = .26). At Site 2 (n = 5), mean days of drinking dropped from 3.1 ± 1.19 to 0.24 ± 0.17 (t = 5.0, df = 4, p = 0.007). At that site, patients were younger, had fewer prior hospitalizations, and the majority (83.3%) were recently in a psychiatric inpatient unit. Conclusion: Quetiapine may hav...
{"title":"An open label study of quetiapine in patients with schizophrenia and alcohol disorders","authors":"M. Brunette, R. Dawson, C. O'Keefe, P. Buckley, A. Green","doi":"10.1080/17523280903156073","DOIUrl":"https://doi.org/10.1080/17523280903156073","url":null,"abstract":"Background: Preliminary studies suggest that quetiapine, a mixed dopaminergic and serotonergic agent used for the treatment of psychosis, may decrease substance use in patients with schizophrenia. Method: A three-month, uncontrolled, open-label prospective study of 23 outpatients with schizophrenia or schizoaffective disorder and co-occurring alcohol use disorder was conducted at two sites. Due to substantial site differences, outcomes are reported separately for each site on the 16 study subjects who completed at least one month of quetiapine treatment (mean dose 472 ± 255 mg). Results: At Site 1 (n = 11), mean days of drinking each week decreased, but not significantly (3.18 ± 1.63 to 2.71 ± 2.32, t = 1.2, df = 10, p = .26). At Site 2 (n = 5), mean days of drinking dropped from 3.1 ± 1.19 to 0.24 ± 0.17 (t = 5.0, df = 4, p = 0.007). At that site, patients were younger, had fewer prior hospitalizations, and the majority (83.3%) were recently in a psychiatric inpatient unit. Conclusion: Quetiapine may hav...","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"36 1","pages":"203-211"},"PeriodicalIF":0.0,"publicationDate":"2009-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79540822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-06-02DOI: 10.1080/17523280902930130
A. Baldacchino, N. Groussard-Escaffre, C. Clancy, C. Lack, K. Sieroslavrska, C. Hodges, L. Merinder, T. Greacen, M. Sorsa, H. Laijarvi, K. Baeck-Moller
Aims: This article sets out to identify the issues that are relevant to understanding the current approaches used to determine the extent of the problems as a result of co-existent substance misuse and mental health problems comorbidity 1 in Europe. It is a fundamental prerequisite that it is based on robust epidemiological processes. Method: This article will describe an attempt to identify current data available in 2002 on the prevalence of co-morbidity per 100,000 inhabitants in Poland (Warsaw), Denmark (Aarhus), Finland (Tampere), England & Wales (London and Cambridge), Scotland (Dundee) and France (Paris) as part of the ISADORA project. Results: This exercise highlights methodological challenges in the epidemiology of comorbidity such as setting, subjects, intervention used and context, conceptual, units of contents, time window and accuracy of resolution and assessment method used. Conclusion: These issues need to be resolved before representative information can be interpreted.
{"title":"Epidemiological issues in comorbidity: lessons learnt from a pan-European ISADORA project","authors":"A. Baldacchino, N. Groussard-Escaffre, C. Clancy, C. Lack, K. Sieroslavrska, C. Hodges, L. Merinder, T. Greacen, M. Sorsa, H. Laijarvi, K. Baeck-Moller","doi":"10.1080/17523280902930130","DOIUrl":"https://doi.org/10.1080/17523280902930130","url":null,"abstract":"Aims: This article sets out to identify the issues that are relevant to understanding the current approaches used to determine the extent of the problems as a result of co-existent substance misuse and mental health problems comorbidity 1 in Europe. It is a fundamental prerequisite that it is based on robust epidemiological processes. Method: This article will describe an attempt to identify current data available in 2002 on the prevalence of co-morbidity per 100,000 inhabitants in Poland (Warsaw), Denmark (Aarhus), Finland (Tampere), England & Wales (London and Cambridge), Scotland (Dundee) and France (Paris) as part of the ISADORA project. Results: This exercise highlights methodological challenges in the epidemiology of comorbidity such as setting, subjects, intervention used and context, conceptual, units of contents, time window and accuracy of resolution and assessment method used. Conclusion: These issues need to be resolved before representative information can be interpreted.","PeriodicalId":88592,"journal":{"name":"Mental health and substance use : dual diagnosis","volume":"9 1","pages":"88-100"},"PeriodicalIF":0.0,"publicationDate":"2009-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77010045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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