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Mental health and substance use : dual diagnosis最新文献

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The effect of amphetamine type stimulants on psychopathology, aggression and cognitive function among clients within a drug therapeutic community 安非他明类兴奋剂对药物治疗社区客户的精神病理、攻击和认知功能的影响
Pub Date : 2009-06-02 DOI: 10.1080/17523280902932656
Alison K. Gunn, D. Rickwood
Background: Increasingly, the use of amphetamine-type stimulants (ATS) has been associated with psychopathology, cognitive deficits, and aggression. These are important co-morbidities that need to be considered, particularly in residential drug treatments. Aims: This study compared levels of aggression, psychopathology, and executive function between participants identified as being ATS or non-ATS users who were residents within Drug Therapeutic Communities (DTCs). Method: A sample of 67 males and 37 females, aged 19–60 years, undertaking residential treatment at one of four DTCs, completed a self-report questionnaire. Participants were grouped as sustained and recent ATS use (n = 51) or prior and no ATS use (n = 53). Results: Psychopathology and executive dysfunction were high among all participants. ATS users exhibited significantly higher levels of depression, executive dysfunction, and aggression compared to non-ATS users, and these measures were highly intercorrelated. Younger age was weakly associat...
背景:越来越多地,安非他明类兴奋剂(ATS)的使用与精神病理、认知缺陷和攻击行为有关。这些是需要考虑的重要合并症,特别是在住院药物治疗中。目的:本研究比较了居住在药物治疗社区(dtc)的ATS使用者和非ATS使用者之间的攻击水平、精神病理学和执行功能。方法:选取男性67人,女性37人,年龄19-60岁,在四家dtc之一接受住院治疗,完成自我报告问卷。参与者被分为持续和最近使用ATS (n = 51)或既往和未使用ATS (n = 53)。结果:所有参与者的精神病理和执行功能障碍均较高。与非ATS使用者相比,ATS使用者表现出更高的抑郁、执行功能障碍和攻击水平,并且这些指标高度相关。年龄越小,关联越弱。
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引用次数: 4
Challenging therapeutic pessimism: borderline personality disorder and co-morbid substance abuse1 挑战治疗悲观主义:边缘型人格障碍和共病药物滥用1
Pub Date : 2009-06-02 DOI: 10.1080/17523280902930122
R. Rossiter, J. Black
The challenges encountered within public mental health services in New South Wales, Australia, have been well described in recent review documents. New South Wales and Federal government policies clearly outline expectations of evidence-based service delivery. Achieving these expectations in urban settings remains a somewhat haphazard process, while service delivery in rural and remote areas often falls markedly short of satisfactory. This article describes the almost overwhelming challenges encountered by a mental health team and drug and alcohol service confronted with a consumer with co-morbid borderline personality disorder (BPD) and a multiple substance abuse disorder. While successful evidence-based treatments for BPD have been described in the literature, therapeutic pessimism remains pervasive in many settings. When a consumer presents with a co-morbid substance abuse disorder, clinicians from both mental health and Drug and Alcohol services at times struggle to develop an effective and collaborat...
在最近的审查文件中,对澳大利亚新南威尔士州公共精神卫生服务中遇到的挑战进行了很好的描述。新南威尔士州和联邦政府的政策明确概述了对基于证据的服务提供的期望。在城市环境中实现这些期望仍然是一个有些偶然的过程,而在农村和偏远地区提供的服务往往远远不能令人满意。这篇文章描述了一个精神健康团队和药物和酒精服务机构面对一个同时患有边缘型人格障碍(BPD)和多重药物滥用障碍的消费者时所遇到的几乎压倒性的挑战。虽然文献中描述了成功的基于证据的BPD治疗方法,但在许多情况下,治疗悲观主义仍然普遍存在。当消费者表现出合并症的药物滥用障碍时,来自精神健康和药物和酒精服务的临床医生有时很难制定有效的合作…
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引用次数: 2
Systematic implementation of integrated dual disorders treatment in The Netherlands 荷兰双重障碍综合治疗的系统实施
Pub Date : 2009-06-02 DOI: 10.1080/17523280902932649
A. V. Wamel, H. Kroon, S. V. Rooijen
Background: In the Netherlands, mental illness and addiction are treated separately. This causes problems when treating dual disorders. There is growing consensus in the Netherlands that the integration of mental health care and addiction care may be the best way to treat dual disorder patients. Aims: This study considered whether Integrated Dual Disorder Treatment (IDDT), developed and researched in the United States, could be implemented in the Netherlands. Method: Five outpatient teams participated in the pilot. American implementation materials were translated, treatment staff trained, dual disorder treatment implemented, and barriers to implementation and strategies to overcome these were considered. The progress of implementation of Integrated Dual Disorder Treatment was followed by fidelity measurements. Results: In the baseline measurement the teams had an average score of 2.2 (5 meaning full implementation). One year later, the average had increased to 3. At the end of the project the average sco...
背景:在荷兰,精神疾病和成瘾是分开治疗的。这在治疗双重障碍时造成了问题。在荷兰,越来越多的人认为,将精神卫生保健和成瘾护理结合起来可能是治疗双重障碍患者的最佳方法。目的:本研究考虑在美国开发和研究的综合双重障碍治疗(IDDT)是否可以在荷兰实施。方法:5个门诊班组参与试点。翻译美国的实施材料,培训治疗人员,实施双重障碍治疗,并考虑实施的障碍和克服这些障碍的策略。对综合双重障碍治疗的实施进展进行保真度测量。结果:在基线测量中,团队的平均得分为2.2分(5分意味着完全执行)。一年后,平均人数增加到3人。在项目结束时,平均sco…
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引用次数: 14
Are patients with a history of illicit drug use perceived to be ‘drug-seeking’ when they request pro re nata medication and does this impact on its administration? 当有非法药物使用史的患者要求自然药物治疗时,他们是否被认为是“寻求药物治疗”?这是否会影响给药?
Pub Date : 2009-06-02 DOI: 10.1080/17523280902930114
S. Kaur, M. Daffern, Stuart D M Thomas
Background: Providing optimal treatment is pivotal to improved health and justice outcomes for patients with dual diagnosis. Unfortunately, the available evidence suggests that these patients may be unduly prejudiced during hospitalisation due to perceptions that their requests for pro re nata (PRN) medication is ‘drug-seeking’, reflecting persistent dependence or tendencies toward abuse of licit and illicit substances. Aims: To examine psychiatric nurses' responses to patients requests for PRN medication, to examine whether these requests are interpreted as ‘drug-seeking’, and to characterise patients described as such. Method: Case files and medication charts of patients diagnosed with schizophrenia admitted to a secure psychiatric service were reviewed to determine (a) their history of drug use, (b) the frequency with which they requested PRN medication, (c) how often staff administered PRN medication following request, and (d) how often patients were labelled ‘drug seeking’. Results: Patients with a h...
背景:提供最佳治疗对于改善双重诊断患者的健康和公正结果至关重要。不幸的是,现有证据表明,这些患者在住院期间可能会受到不适当的偏见,因为他们认为他们对自然(PRN)药物的请求是“寻求药物”,反映出对合法和非法药物的持续依赖或滥用倾向。目的:检查精神科护士对患者请求PRN药物的反应,检查这些请求是否被解释为“寻求药物”,并描述患者的特征。方法:对被诊断为精神分裂症的患者的病例档案和药物图表进行审查,以确定(a)他们的药物使用史,(b)他们要求PRN药物的频率,(c)工作人员根据要求给予PRN药物的频率,以及(d)患者被标记为“寻求药物”的频率。结果:a型肝炎患者…
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引用次数: 3
A report on the ‘Keep Your Head Together’ project: a dual diagnosis population health prevention initiative undertaken in Western Sydney, Australia 一份关于“保持头脑清醒”项目的报告:在澳大利亚西悉尼开展的双重诊断人口健康预防倡议
Pub Date : 2009-06-02 DOI: 10.1080/17523280902932631
Stewart Stubbs, L. Maher, Elizabeth O'Neil
Dual diagnosis is common among substance-using adolescent populations. Increasingly, young people are presenting to mental health and drug and alcohol service providers with dual diagnosis issues. Early intervention and treatment services are being researched and developed. However, there are few programmes established in the area of prevention. A comprehensive population health-based dual diagnosis prevention project incorporating community education, resource development, community awareness raising, and professional training was undertaken in Western Sydney, Australia. Evaluations demonstrated that a multifaceted strategy was effective in raising community awareness, generating help-seeking behaviour in individuals concerned about dual diagnosis, increasing knowledge and confidence of professionals working in the field, and establishing sustaining partnerships to extend the reach of the project beyond initial funding parameters. Potentially sensitive issues such as dual diagnosis and substance use can ...
双重诊断在青少年吸毒人群中很常见。越来越多的年轻人因双重诊断问题向心理健康和药物及酒精服务提供者就诊。正在研究和开发早期干预和治疗服务。但是,在预防领域制订的方案很少。在澳大利亚西悉尼开展了一项以人口健康为基础的综合双重诊断预防项目,包括社区教育、资源开发、提高社区认识和专业培训。评价表明,多方面的战略有效地提高了社区的认识,使关心双重诊断的个人产生寻求帮助的行为,增加了在该领域工作的专业人员的知识和信心,并建立了持续的伙伴关系,将项目的范围扩大到最初的供资范围之外。双重诊断和药物使用等潜在的敏感问题可能……
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引用次数: 0
Depression, hostility, and substance use among university students in Jordan 约旦大学生的抑郁、敌意和药物使用
Pub Date : 2009-01-13 DOI: 10.1080/17523280802593301
A. Hamdan-Mansour, J. Halabi, H. Dawani
Background: University students are a target population for a number of research studies due to a high prevalence of mental health and psychosocial problems. Aims: To examine the relationship between depressive symptoms, hostility, and substance use among university students in Jordan. Methods: This is a descriptive correlation study. Data were collected on demographics, depressive symptoms, hostility, and substance use from 572 university students in Jordan. Results: Almost 75% of the university students exhibited some degree of depressive symptoms. Tobacco, painkillers, stimulants, tranquilizers, inhalants, and alcohol respectively were the most used substances. Depressive symptoms were positively correlated with hostility and tobacco use. Similarly, depression had a positive correlation with the frequency of using painkillers, inhalants, stimulants, tranquilizers, and heroin. Male and female university students were not different in their depressive symptoms, hostility, and frequency of substance use. ...
背景:由于心理健康和社会心理问题的高发,大学生是许多研究的目标人群。目的:研究约旦大学生抑郁症状、敌意和药物使用之间的关系。方法:采用描述性相关研究。收集了约旦572名大学生的人口统计学、抑郁症状、敌意和物质使用方面的数据。结果:近75%的大学生表现出不同程度的抑郁症状。烟草、止痛药、兴奋剂、镇定剂、吸入剂和酒精分别是使用最多的物质。抑郁症状与敌意和吸烟呈正相关。同样,抑郁症与使用止痛药、吸入剂、兴奋剂、镇定剂和海洛因的频率呈正相关。男女大学生在抑郁症状、敌意和物质使用频率. ...方面没有差异
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引用次数: 48
Factors associated with retention in a long-term residential rehabilitation programme for women with substance use problems 有药物使用问题的妇女在长期住宅康复方案中滞留的相关因素
Pub Date : 2009-01-13 DOI: 10.1080/17523280802593285
Kristy Johns, A. Baker, R. Webster, T. Lewin
Background: Retention in substance abuse treatment is difficult but essential for positive post-treatment outcomes. Aims: The present study is the first to explore factors related to retention in a long-term specialist residential substance abuse treatment programme for women in Australia. Methods: Archival data (e.g. socio-demographic, substance use, mental health, and length of stay) were collected from a sample of 71 women admitted to the programme between January 1997, and November 2002. Participants were divided into two groups based on their length of stay in the programme: less than 90 days (n = 42) and 90 days or more (n = 29). Results: A substantial proportion of the sample experienced comorbid substance abuse and mental health problems, with 60.6% (n = 43/71) reporting evidence of comorbidity (either a previous psychiatric diagnosis, or having been prescribed psychiatric medications). Overall, only 13% of residents completed the programme. Longer retention was associated with demographic (older ...
背景:保持药物滥用治疗是困难的,但对治疗后的积极结果至关重要。目的:目前的研究是第一个探索与澳大利亚妇女长期专业住宅药物滥用治疗方案中保留相关的因素。方法:从1997年1月至2002年11月期间加入该方案的71名妇女样本中收集档案数据(如社会人口统计学、药物使用、心理健康和住院时间)。参与者根据他们在项目中的停留时间分为两组:少于90天(n = 42)和90天或以上(n = 29)。结果:相当大比例的样本经历了药物滥用和精神健康问题的共病,60.6% (n = 43/71)报告了共病的证据(以前有精神病学诊断,或者开过精神科药物)。总的来说,只有13%的居民完成了这个项目。更长的留存率与人口统计学(年龄更大……
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引用次数: 10
Self-reported reasons for substance use in schizophrenia: a Q methodological investigation 精神分裂症患者自我报告的药物使用原因:一项Q方法学调查
Pub Date : 2009-01-13 DOI: 10.1080/17523280802593293
L. Gregg, G. Haddock, C. Barrowclough
Background: Large numbers of people with a diagnosis of schizophrenia use drugs and alcohol, resulting in poorer symptomatic and functional outcomes for many. Aims: To examine the reasons that people with a diagnosis of schizophrenia give for their own alcohol and drug use. Method: Q methodology was used to examine reasons for use. Forty-five people with a diagnosis of schizophrenia or schizoaffective disorder and comorbid substance misuse completed the sorting procedure. Results: Analysis of the Q Sorts revealed three distinct groups of substance users: (1) those who predominantly used for social and enhancement reasons, to ‘chill out and have a good time with others:’ (2) those who used to regulate negative affect and alleviate positive symptoms, to ‘cope with distressing emotions and symptoms:’ (3) those who used substances to augment themselves and intensify their experiences, to ‘feel bigger, better and inspired.’ Conclusion: People with a diagnosis of schizophrenia who use substances explain their s...
背景:大量被诊断为精神分裂症的人使用药物和酒精,导致许多人的症状和功能预后较差。目的:研究被诊断为精神分裂症的人对自己酗酒和吸毒的原因。方法:采用Q方法分析使用原因。45名被诊断为精神分裂症或分裂情感障碍和共病药物滥用的人完成了分类程序。结果:对Q类型的分析揭示了三种不同的药物使用者群体:(1)主要出于社交和增强能力的原因使用药物的人,“放松下来,与他人共度美好时光”;(2)用于调节负面影响和缓解积极症状的人,“应对痛苦的情绪和症状”;(3)使用药物来增强自我和强化体验的人,“感觉更强大、更好、更有灵感”。结论:被诊断为精神分裂症的人使用药物来解释他们的行为……
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引用次数: 24
The fall and rise of Richard Shrubb 理查德·施罗布的起起落落
Pub Date : 2009-01-13 DOI: 10.1080/17523280802630277
Richard Shrubb
Events leading to my breakdown. My view on recovery. Medical treatment, followed by the time to get over that treatment. That time should be used in preparing for life after care. Training, leading to employment – employment leading to life after being a psychiatric patient. My original intentions on being diagnosed with mental illness – recover, get a trade, get a job, get a life!’
导致我崩溃的事情。我对复苏的看法。药物治疗,然后是克服治疗的时间。这段时间应该用来为护理后的生活做准备。培训,导向就业,就业导向精神病患者后的生活。我被诊断出患有精神疾病的初衷是——康复,找到一份工作,找到一份生活!”
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引用次数: 0
A review of research on smoking cessation interventions for adults with schizophrenia spectrum disorders 成人精神分裂症谱系障碍戒烟干预研究综述
Pub Date : 2009-01-13 DOI: 10.1080/17523280802593327
Joelle C Ferron, A. Alterman, G. McHugo, M. Brunette, R. Drake
Background: Recent studies show that 75–85% of people with schizophrenia spectrum disorders in the United States smoke cigarettes, compared with 23% of the general population. Moreover, people with these illnesses on average have life expectancies 25 years lower than the general population, and smoking is a contributor. Aims: To review intervention research and evaluate the methods and clinical findings associated with attempts to eliminate, or reduce, smoking in people with schizophrenia spectrum disorders. Methods: PubMed and PsychInfo were searched from early 1990 through 2007 with select keywords. Thirteen treatment studies addressing smoking cessation interventions in people with schizophrenia spectrum disorders or severe mental illness were identified. Results: Nicotine replacement therapy, psychosocial interventions, and bupropion have been studied. Overall, treatment compliance was moderate, quit rates were low, and relapse to smoking was high. Modest evidence supports the efficacy of bupropion an...
背景:最近的研究表明,美国75-85%的精神分裂症谱系障碍患者吸烟,而普通人群的这一比例为23%。此外,患有这些疾病的人的平均预期寿命比普通人群低25年,吸烟是一个因素。目的:回顾干预研究,评价在精神分裂症谱系障碍患者中试图消除或减少吸烟的方法和临床结果。方法:检索1990年初至2007年PubMed和PsychInfo的精选关键词。确定了13项针对精神分裂症谱系障碍或严重精神疾病患者戒烟干预的治疗研究。结果:研究了尼古丁替代疗法、社会心理干预和安非他酮。总体而言,治疗依从性中等,戒烟率低,复发率高。适度的证据支持安非他酮和…
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引用次数: 20
期刊
Mental health and substance use : dual diagnosis
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