Journal of Dual Diagnosis最新文献

{"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}

{"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}

{"title":"Clinical Characteristics of Early Leavers From a Private Dual-Diagnosis Program.","authors":"Justin Huft, Timothy Fong, Elizabeth Hall, Farrah K Khaleghi Aizenman, Tal Leshem","doi":"10.1080/15504263.2024.2434434","DOIUrl":"10.1080/15504263.2024.2434434","url":null,"abstract":"<p><p><b>Objective:</b> Early leaving in substance use disorder treatment may be the single largest variable undermining treatment success. Existing work on early leaving tends to explore either client factors, which include age, race, gender, and diagnoses, or treatment factors, which include the type of treatment activities offered, treatment experiences of clients and staff, treatment amenities, and environmental factors in the residential treatment program. However, existing work on both client factors and treatment factors provides mixed results on what contributes to early leaving. Further, there has been very little research in the private residential treatment setting. This study aims to explore the factors influencing early leaving in a private residential treatment setting. <b>Methods:</b> The study analyzed admission and treatment records from 247 consecutive clients at a private treatment facility in Southern California to identify factors related to shorter retention. The program employs a biopsychosocial approach and evidence-based practices to assist clients in recovery from substance use disorders and mental health conditions. We utilize a battery of client measures, including the Outcome Questionnaire 45.2, Trauma History Questionnaire, as well as demographic and psychiatric variables in our analyses. <b>Results:</b> Findings challenge previous research by showing that age and gender do not predict shorter retention, contrary to findings in the extant literature on public treatment centers. Instead, clients with higher symptoms of distress stay longer, as indicated by scores on the Outcome Questionnaire 45.2. Additionally, we find the majority of the cohort stayed in residential treatment for more than 30 days, with the average length of stay being 47.92 days, indicating that treatment completion of clients with severe symptomatology for an extended time in treatment (30 days or more) is achievable. <b>Conclusions:</b> The study underscores the importance of considering client symptomologies and severities in understanding and improving retention in substance use disorder treatment programs. This study highlights the potential impact of treatment services offered in private settings on client retention.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"24-34"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802305","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}

{"title":"Highlights for the <i>Journal of Dual Diagnosis</i> from 2024.","authors":"E Sherwood Brown","doi":"10.1080/15504263.2024.2440416","DOIUrl":"10.1080/15504263.2024.2440416","url":null,"abstract":"","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956687","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}

{"title":"The Role of Functional Health Literacy in Terms of Hazardous Alcohol Use in Adults with Probable Posttraumatic Stress Disorder and Alcohol Use Disorder.","authors":"Dylan A Gould, Rebecca E Lubin, Shelby J McGrew, Tanya Smit, Anka A Vujanovic, Michael W Otto, Michael J Zvolensky","doi":"10.1080/15504263.2024.2433775","DOIUrl":"10.1080/15504263.2024.2433775","url":null,"abstract":"<p><p><b>Objective:</b> Co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) represents a prevalent and problematic comorbidity. Functional health literacy (FHL) may play a role in this comorbidity based on its previously documented role in hazardous drinking. The current study examined functional health literacy (FHL) regarding hazardous drinking among a sample with probable posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). <b>Methods:</b> The current study is a secondary analysis of data from a project studying the transdiagnostic risk and maintenance factors of PTSD and hazardous alcohol use among people with probable PTSD and AUD. Participants were 565 nationally recruited adults with probable PTSD and hazardous alcohol use (52.2% female, 68.8% non-Hispanic White, average age = 39.2 years ± 10.9 years). Linear regression models were conducted regressing hazardous alcohol use onto PTSD symptoms and FHL scores. An interaction term between FHL and PTSD symptoms was included in the regression models with age, biological sex, race, and income included as covariates. <b>Results:</b> Low FHL maintained a statistically significant role in predicting greater hazardous drinking (<i>p</i> < .001) even in the context of posttraumatic stress. High posttraumatic stress also emerged as a statistically significant predictor of hazardous alcohol use (<i>p</i> < .001). The interaction term between FHL and PTSD was not found to be a significant predictor of hazardous alcohol use (<i>p</i> = .222). <b>Conclusion:</b> FHL may be a relevant variable for better understand hazardous drinking among persons with comorbid PTSD and AUD.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"49-55"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problematic Substance Use in Depressed Youth: Associations with Suicidal Ideation and Suicide Attempt History.","authors":"Gabrielle M Armstrong, Jacey L Anderberg, April R Gorman, Samuel D Spencer, Abu Minhajuddin, Anthony H Ecker, Jessica Spofford, Andrew G Guzick, Holli Slater, Fuad Z Aloor, Annelise M Flores, Jacquelyn M Lagrone, Elise N Marino, Cesar A Soutullo, Sarah M Wakefield, Wayne K Goodman, Madhukar H Trivedi, Eric A Storch","doi":"10.1080/15504263.2024.2434219","DOIUrl":"10.1080/15504263.2024.2434219","url":null,"abstract":"<p><p><b>Objective:</b> Depressed youth exhibit higher rates of suicidal behavior compared to healthy controls, with problematic substance use potentially intensifying this risk. Accordingly, this study aimed to examine the impact of comorbid depression and problematic substance use and its association with suicidality in youth populations. <b>Methods:</b> We examined differences in clinical features and demographic characteristics between 797 depressed youth ages 8-20 years with and without problematic substance use from the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Additionally, to assess whether the effect of depression severity on suicidal ideation and suicide attempt history were influenced by problematic substance use, multivariable linear and logistic regression analyses were conducted. <b>Results:</b> Depressed youth with problematic substance use (versus those without) were significantly older, more likely to exhibit suicidal ideation and a history of suicide attempts and had significantly worse school functioning after controlling for age, sex, race, and ethnicity. Problematic substance use did not moderate the effect of depression severity on suicidal ideation or suicide attempt history. <b>Conclusions:</b> Findings shed light on the impact of problematic substance use in depressed youth which may allow for earlier and more specified intervention efforts aimed at identifying and targeting youth suicidality.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"35-48"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773629","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}

{"title":"Mapping the Pathways Between Posttraumatic Stress Disorder, Depression, and Alcohol and Cannabis Use: A Network Analysis.","authors":"Rachel E Williamson, Kathryn S Macia, Joshua Burton, Robert E Wickham","doi":"10.1080/15504263.2024.2330620","DOIUrl":"10.1080/15504263.2024.2330620","url":null,"abstract":"<p><p><b>Objective:</b> The present study examines the network structure and, using Bayesian network analysis, estimates the directional pathways among symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and levels of alcohol and cannabis use. <b>Method:</b> A sample of 1471 adults in the United States, who reported at least one potentially traumatic event, completed the PTSD Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), and the Alcohol/Cannabis Use Disorders Identification Test (AUDIT/CUDIT). A regularized partial correlation network provided estimates of symptoms clusters and connections. Directional pathways within the network were then estimated using a directed acyclic graph (DAG). <b>Results:</b> Symptoms clustered in theoretically consistent ways. Risky behavior demonstrated the highest strength centrality and bridge strength. Neither alcohol nor cannabis use appeared central in the network, and DAG results suggested that MDD and PTSD symptoms are more likely to lead to substance use than the other way around. <b>Conclusions:</b> Results suggest that cannabis use is largely connected to alcohol use. Consistent with prior research, risky behavior appeared to be the primary bridge between substance use and PTSD. The direction of associations between substance use and psychological symptoms requires further attention.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"318-326"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332171","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}

{"title":"Nationwide Assessment of Chronic Pain among Hospitalized Individuals with Co-occurring Post Traumatic Stress Disorder and Substance Use Disorder in the United States.","authors":"Olaniyi Olayinka, Brook T Alemu, Stanley Nkemjika, Declan T Barry","doi":"10.1080/15504263.2024.2347489","DOIUrl":"10.1080/15504263.2024.2347489","url":null,"abstract":"<p><p><b>Objective:</b> Chronic pain (CP) is independently associated with substance use disorders (SUD) and posttraumatic stress disorder (PTSD). However, little is known about factors associated with CP among patients with co-occurring PTSD and SUD. Patterns of hospital resource usage should also be explored further. <b>Methods:</b> Using the 2019 National Inpatient Sample (NIS), we identified 216,125 hospital discharges with co-occurring diagnoses of PTSD and SUD in 2019 and examined their association with CP. Multivariable logistic regression models were used to identify factors associated with an increased likelihood of CP in this cohort. <b>Results:</b> Among those with co-occurring PTSD and SUD (<i>N</i> = 216,125), 35,450 had associated CP, a prevalence of 164.02 cases per 1,000 discharges (95% CI [160.54, 167.52]). Individuals aged 55-64 with co-occurring PTSD and SUD were approximately 7.2 times more likely to experience CP, compared to those aged 16-24 (OR = 7.2; 95% CI [6.09, 8.60]). Being in the CP group was associated with 50% increased odds of insomnia and obesity (OR = 1.5; 95% CI [1.12, 2.03] and OR = 1.5; 95% CI [1.38, 1.55], respectively), 30% increased odds of anxiety (OR = 1.3; 95% CI [1.24, 1.38]), 20% increased odds of attention deficit disorder (ADD;OR = 1.2; 95% CI [1.12, 1.38]) and 10% increased odds of depression (OR = 1.1; 95% CI [1.01, 1.14]). Compared with females, being male was associated with slightly decreased odds of CP (OR = 0.9; 95% CI [0.84, 0.94]). <b>Conclusions:</b> Among hospitalized Americans with co-occurring PTSD and SUD, advanced age, being female, and the presence other mental health disorders were associated with an increased risk of CP. Providers treating co-occurring PTSD/SUD should evaluate for and consider evidence-based management of CP if present.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"340-349"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866549","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}

{"title":"Spirituality/Religion Among First Responders With and Without Posttraumatic Stress Disorder and Alcohol Misuse.","authors":"Caroline C Kaufman, R Kathryn McHugh, Mia Drury, Julia G Merrill, David H Rosmarin","doi":"10.1080/15504263.2024.2330619","DOIUrl":"10.1080/15504263.2024.2330619","url":null,"abstract":"<p><p><b>Objective:</b> To examine the co-occurrence of alcohol misuse and posttraumatic stress disorder (PTSD) and potential sources of coping (e.g., spirituality/religion) and clinically relevant variables among first responders (e.g., firefighters, law enforcement corrections officers, paramedics). <b>Method:</b> We assessed rates of independent and co-occurring alcohol misuse and PTSD among a national online sample of 320 first responders as well as the prevalence and salience of S/R, guilt, shame, moral injury, aspects of S/R, and treatment interest. <b>Results:</b> In our sample, 46.88% (<i>n</i> = 150) met criteria for comorbid alcohol misuse and probable PTSD and individuals with these comorbid conditions reported significantly greater negative religious coping, moral injury, and shame than all other diagnostic groups (i.e., independent alcohol misuse, independent PTSD, and neither). Correlations also revealed significant relationships between alcohol misuse and PTSD symptomatology with positive and negative religious coping, moral injury, shame, guilt, interest in treatment, and interest in spiritually integrated treatment. <b>Conclusions:</b> Findings highlight the high rates of independent and co-occurring alcohol misuse and PTSD among first responders as well as the salience of S/R in this population.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"291-302"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337180","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}

{"title":"Substance Use Disorder Admission Rates Before and After the Lockdown in a Large Addiction Center in Saudi Arabia: A Retrospective Cohort Study.","authors":"Majed Ramadan, Yara F Batwa","doi":"10.1080/15504263.2024.2351449","DOIUrl":"10.1080/15504263.2024.2351449","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to examine the potential changes in substance use disorder (SUD) admission rates before and after the lockdown in a major addiction center in Saudi Arabia. <b>Method:</b> This retrospective cohort study extracted data from Al-Amal Hospital Electronic Health Record in the city of Dammam, Eastern region of Saudi Arabia. A total of 2,426 cases included in the analysis for patients who received services from the SUD treatment programs from 1/1/2015 to 31/12/2021. <b>Results:</b> Before the pandemic, there was a consistent increase in the admission rates for patients with substance use disorder. The highest proportion of increase were among unemployed, young, newly admitted patients. During lockdown, there was nearly a 70% reduction in SUDs-related admission rate. The age group 18-25 was seven-times more likely to be admitted for SUD after the lockdown. Amphetamine-related admissions were two times more likely to be admitted after the lockdown (Odds ratio (OR) 2.04; confidence interval (CI) 95%[1.64, 2.54]). <b>Conclusions:</b> There was nearly 70% reduction in SUDs admission rates during the lockdown. After the lockdown, a significant proportional increase in amphetamine use disorder admissions was observed mostly among the patients age group 18-24 with a history of a previous admissions. Determining populations at risk for high health care utilization is crucial in building a comprehensive and effective prevention strategy. Therefore, the need to adopt coordinated strategies and innovative, comprehensive approaches to benefit individuals with SUD is imperative to face the increased rate of SUD related admissions.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"350-358"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284999","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}