Journal of Dual Diagnosis最新文献

{"title":"Concurrent Depression Management in Patients with Opioid Use Disorder Undergoing Buprenorphine Therapy: Association with Buprenorphine Discontinuation.","authors":"Vaishnavi Tata, Tyler J Varisco, Dipali V Rinker, Susan Abughosh, Clay Rhodes, J Douglas Thornton","doi":"10.1080/15504263.2025.2474949","DOIUrl":"10.1080/15504263.2025.2474949","url":null,"abstract":"<p><p><b>Objective:</b> The relationship between concurrent depression and Opioid Use Disorder (OUD) treatment outcomes remains incompletely understood. Prior studies found mixed results regarding the impact of psychiatric comorbidities on retention to medications for OUD. This study aims to evaluate how the receipt of pharmacotherapy for depression impacts retention to buprenorphine therapy among patients with OUD and concurrent depression. <b>Methods:</b> We conducted a retrospective cohort study using the Humana Healthcare Research claims database (2014-2020) on a sample of adult patients who initiated buprenorphine for OUD between January 2015, and September 2019. Patients were required to have a 180-day buprenorphine-free period pre-index. Patients with concurrent depression were identified via diagnosis in a medical claim within the baseline period. Antidepressant use was defined as cumulative exposure from the start of the baseline through the end of the 180-day follow-up period. The primary outcome was time to buprenorphine discontinuation, defined as a gap of more than 30 days from the day of last supply. Cox Proportional Hazards regression was used to estimate the association between antidepressant receipt and buprenorphine discontinuation. Sensitivity analyses on specific classes of antidepressants were also conducted. <b>Results:</b> The final analytical cohort included 1,973 patients with OUD and concurrent depression. Of these, 235 (11.91%) discontinued buprenorphine during the follow-up period, with a mean time to discontinuation of 97.92 (±68.64) days. Survival analysis revealed that patients who received antidepressants had a significantly lower hazard of discontinuation [aHR (95% CI): 0.995 (0.994, 0.996); <i>p <</i> .0001]. Initiated dose of buprenorphine also had a significant effect on the hazard of discontinuation [0.976 (0.956, 0.997); <i>p =</i> .0270]. <b>Conclusions:</b> Our findings support the notion that continuation of antidepressants when initiating buprenorphine therapy for OUD positively influences buprenorphine retention among patients with OUD and concurrent depression.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"142-151"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765350","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":"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":"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":"99-108"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021548/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"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":"120-141"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","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}

{"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}

{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050072/pdf/","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":"OA","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":"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":"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":"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":"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}