Journal of Dual Diagnosis最新文献

{"title":"Eligibility for Substance Use Clinical Trials Among Emergency Psychiatry Patients: The Impact of Exclusion Criteria.","authors":"Ryan E Lawrence, Adam Bernstein, Chaya Jaffe, Yinjun Zhao, Yuanjia Wang, Terry E Goldberg","doi":"10.1080/15504263.2024.2377100","DOIUrl":"https://doi.org/10.1080/15504263.2024.2377100","url":null,"abstract":"<p><p><b>Objective:</b> The first objective was to identify common exclusion criteria used in clinical trials. The second objective was to quantify the degree to which these criteria exclude emergency psychiatry patients. <b>Methods:</b> Qualitative Content Analysis was used for the first objective, identifying common exclusion criteria used in recent high-impact substance use clinical trials. A retrospective record review was used for the second objective, which examined the frequency of these exclusion criteria in a 1-month sample of adults receiving psychiatric evaluation in an emergency department. <b>Results:</b> Most trials had exclusions for co-occurring psychiatric problems (76.6%), medical problems (74.0%), prior or current treatment (72.7%), motivation for change (61.1%), pregnancy or lactation (57.1%), or using other specified substances of abuse (54.6%). In the clinical sample, exclusions for co-occurring psychiatric problems would make 94.7% of patients ineligible. Other exclusions had a combined effect of making 76% of patients ineligible. <b>Conclusions:</b> Clinical trials using typical exclusion criteria exclude nearly all emergency psychiatry patients with substance use problems.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621197","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":"Individual Trajectories of Specialist Substance Use Disorder and Mental Health Treatment Utilization Among Young Adults With Substance Use Problems: A Cohort Study.","authors":"Regine Bakken, Jūratė Š Benth, Halvor Fauske, Lars Lien, Anne S Landheim","doi":"10.1080/15504263.2024.2341092","DOIUrl":"10.1080/15504263.2024.2341092","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to identify groups of young adults with distinct longitudinal patterns of use of treatment for substance use disorders and mental health (MH) problems and to investigate potential explanatory factors for different patterns of treatment use over time, including sociodemographic factors.</p><p><strong>Methods: </strong>The sample consisted of 447 young adults aged 16-29 years who entered long-term residential substance use disorder treatment facilities in Norway from 2011 to 2016. In this study, we obtained data collected by the Norwegian Patient Registry and Statistics Norway. These data were linked with the electronic health record data of the substance use disorder treatment facilities from which the participants were recruited. Growth mixture modeling was performed. The identified groups were further compared using analysis of variance or <i>χ</i>² test.</p><p><strong>Results: </strong>Four groups of participants for total treatment use, substance use disorder treatment use, and MH treatment use were identified. Most participants from the overall sample were classified as members of a group characterized by a low and stable pattern of treatment use over time. A group with a high and stable pattern of treatment use was identified in total and MH treatment use. The proportion of participants with higher levels of substance use disorder treatment use at the end of the study period than at the beginning was larger (35%) than in the case of MH treatment use (14.2%). Younger age was associated with a decreasing pattern of MH treatment use and with an increasing pattern of substance use disorder treatment use over time. There were larger proportions of female participants in groups with a stable high use of MH treatment and in groups with an initially increasing trend of substance use disorder treatment use. Findings revealed that most participants across the identified groups were recipients of welfare benefits, had low educational attainment, and were not working.</p><p><strong>Conclusions: </strong>Results demonstrated significant variation in trajectories of treatment use among young adults with substance use disorder. Differences in treatment use could indicate differences in symptom severity and complexity. In this study, treatment use was associated with socioeconomic factors, sex, and age. Integrative approaches, including interagency and interdisciplinary collaboration, will often be necessary to sufficiently address the multidimensionality of substance use disorder.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"251-265"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854135","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":"Which Factors Are Associated With Comorbid Psychiatric Conditions in Patients Affected by Substance Use Disorders? The Impact of COVID-19 Pandemic on Dual-Diagnosis Subjects.","authors":"Ilaria Tagliabue, Alice Caldiroli, Enrico Capuzzi, Riccardo Borgonovo, Alberto Scalia, Alessandro Ferrè, Matteo Sibilla, Marco Turco, Letizia M Affaticati, Giovanna Crespi, Giovanni Galimberti, Antonios Dakanalis, Fabrizia Colmegna, Massimiliano Buoli, Massimo Clerici","doi":"10.1080/15504263.2024.2346519","DOIUrl":"10.1080/15504263.2024.2346519","url":null,"abstract":"<p><strong>Objective: </strong>To investigate demographic/cinical variables associated to dual diagnosis and the psychological reaction of dual-diagnosis patients to COVID-19 pandemic.</p><p><strong>Methods: </strong>Information was collected at the Addiction Service of Monza, Italy. The Impact of Event Scale-Revised (IES-R), a self-report questionnaire measuring the subjective response to a traumatic event, was administered. Univariate analyses and binary logistic regression were performed. IES-R scores were compared between groups defined by qualitative variables through one-way analyses of variance (ANOVA).</p><p><strong>Results: </strong>118 outpatients were included, 48.3% with dual diagnosis. Alcohol use disorder and being female were associated to dual diagnosis. IES-R scores were significantly higher in the dual-diagnosis group, especially for personality disorders (PDs). IES-R scores were higher in patients taking treatment for substance use disorder (SUD).</p><p><strong>Conclusions: </strong>Females and alcohol abusers were at-risk subjects for dual diagnosis. Patients with SUD and PDs may benefit from additional support, especially when traumatic life events occur.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04694482.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"201-209"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904935","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":"Factors Associated With Increased Substance Use Disorder Care in VA PTSD Specialty Outpatient Treatment.","authors":"Quyen Q Tiet, Laila Davis, Craig Rosen, Sonya B Norman, Yani E Leyva, Heather Duong","doi":"10.1080/15504263.2024.2348105","DOIUrl":"10.1080/15504263.2024.2348105","url":null,"abstract":"<p><strong>Objective: </strong>Substance use disorders (SUDs) commonly co-occur with posttraumatic stress disorder (PTSD). Understanding PTSD clinics that serve higher percentages of patients with PTSD/SUD is crucial for improving SUD care in clinics with lower percentages of such patients. This study examined the differences between Veterans Affairs (VA) PTSD treatment sites with higher percentages (\"High%\") and lower percentages (\"Low%\") of patients with PTSD/SUD as well as exploring the roles of the PTSD/SUD specialists.</p><p><strong>Methods: </strong>The study collected quantitative and qualitative data from 18 clinic directors and 21 specialists from 33 VA PTSD specialty outpatient clinics from 2014 to 2016. The clinics were chosen from the top and bottom quartiles based on two criteria: (1) the percentage of patients with PTSD/SUD and (2) the percentage of patients with PTSD/SUD who completed at least three SUD visits within the first month of their SUD treatment. The interviews sought to identify distinguishing characteristics between the High% and Low% clinics in terms of treatment access and practices for patients with PTSD/SUD.</p><p><strong>Results: </strong>More of the High% clinics reported providing evidence-based, patient-centered, and integrated/concurrent PTSD/SUD treatment and had staff members with more up-to-date knowledge and skills than the Low% clinics. We also found the roles of the PTSD/SUD specialists were demanding and confusing, leading to high turnover rates.</p><p><strong>Conclusions: </strong>The two groups of PTSD clinics differed in three key factors: Resources, knowledge and skills of staff members, and local policies. Future research should focus on addressing resource limitations, knowledge gaps, and local policy disparities in Low% clinics. By emulating the practices of High% clinics, VA PTSD clinics can improve SUD care for patients with PTSD/SUD.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"223-235"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852837","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":"Examining Profiles and Treatment Outcomes in Dual Diagnosis: Comparison of Coordinated Treatment With Mental Health Services Versus Addiction Center Alone. A Real-World Data Analysis.","authors":"Cinta Mancheño-Velasco, Marta Narváez-Camargo, Daniel Dacosta-Sánchez, Manuel Sánchez-García, Óscar M Lozano","doi":"10.1080/15504263.2024.2323976","DOIUrl":"10.1080/15504263.2024.2323976","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this work was to examine the profile and treatment outcomes of patients with dual pathology depending on whether the patients were attending addiction centers or are being treated in a coordinated model by mental health services.</p><p><strong>Methods: </strong>Data from 7225 dual diagnosis patients were used, of whom 2417 (33.5%) received treatment in the mental health coordinated modality. Clinical information was taken from the patients' electronic health record.</p><p><strong>Results: </strong>Differences were found in patients' sociodemographic and comorbidity profiles according to treatment modality. In general, coordinated care yielded favorable outcomes (higher attendance and lower dropout rates but no differences in retention). The logistic regression analysis identified predictors of patient profiles in coordinated care, emphasizing having a severe mental health disorder (OR = 3.878, 95% CI [3.443, 4.368]; <i>p</i> = .000), being referred by social/health services, or having retired status. Main differences were observed according to the comorbid diagnosis presented, particularly in cases in which the patient had impulse control, hyperkinetic, or cluster C personality disorder.</p><p><strong>Conclusions: </strong>While therapeutic outcomes are influenced by associated comorbidities, the disorders prognosis can be favorable with appropriate treatment. Furthermore, analysis of differences according to treatment modality allows for predicting the type of patient who will receive a particular service, which enables the development of tailored treatments.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"266-278"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120962","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":"Implications of Impulsivity on Criminal Behavior in Individuals With Substance Use Disorder.","authors":"Esther Hernández Fantin, Daniela Benzano, Felipe Ornell, Andressa Goldman Ruwel, Lisia von Diemen, Felix Henrique Paim Kessler, Jaqueline Bohrer Schuch","doi":"10.1080/15504263.2024.2370411","DOIUrl":"https://doi.org/10.1080/15504263.2024.2370411","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to analyze the association between criminal behavior and impulsivity in individuals with drug addiction and investigate whether impulsiveness mediates the relationship between drug use severity and legal problems.</p><p><strong>Methods: </strong>This cross-sectional study included 773 men diagnosed with addiction (295 alcohol users and 478 users of crack/polysubstance) while undergoing addiction treatment. The BIS-11 and ASI-6 were applied to assess impulsivity, criminal behavior, and drug use.</p><p><strong>Results: </strong>The prevalence of criminal behavior was 41.7% (<i>n</i> = 123) in alcohol users and 64.9% (<i>n</i> = 310) in users of crack/polysubstance. Earlier use of different substances and higher impulsivity scores were observed in individuals with criminal history. Mediation analyses revealed that impulsiveness acts as a mediator factor between substance use and criminal behavior, enhancing the severity of legal problems.</p><p><strong>Conclusion: </strong>Our findings can help in deciding on tailored treatment strategies, focusing not only on substance use, but also on the prevention of social problems, criminality, and impulsivity.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459811","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":"Clusters Based on Within-Treatment Symptom Trajectories as Predictors of Dropout in Treatment for Posttraumatic Stress Disorder and Substance Use Disorder.","authors":"Elizabeth Alpert, Adam Kaplan, David Nelson, David W Oslin, Melissa A Polusny, Erin P Ingram, Shannon M Kehle-Forbes","doi":"10.1080/15504263.2024.2355953","DOIUrl":"https://doi.org/10.1080/15504263.2024.2355953","url":null,"abstract":"<p><p><b>Objective:</b> Dropout rates are high in treatments for co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUDs). We examined dropout predictors in PTSD-SUD treatment. <b>Methods:</b> Participants were 183 veterans receiving integrated or phased motivational enhancement therapy and prolonged exposure. Using survival models, we examined demographics and symptom trajectories as dropout predictors. Using latent trajectory analysis, we incorporated clusters based on symptom trajectories to improve dropout prediction. <b>Results:</b> Hispanic ethnicity (integrated arm), Black or African American race (phased arm), and younger age (phased arm) predicted dropout. Clusters based on PTSD and substance use trajectories improved dropout prediction. In integrated treatment, participants with consistently-high use and low-and-improving use had the highest dropout. In phased treatment, participants with the highest and lowest PTSD symptoms had lower dropout; participants with the lowest substance use had higher dropout. <b>Conclusions:</b> Identifying within-treatment symptom trajectories associated with dropout can help clinicians intervene to maximize outcomes. ClinicalTrials.gov Identifier: NCT01211106.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284998","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":"Artificial Neural Network Analysis Examining Substance Use Problems Co-Occurring with Anxiety and Depressive Disorders Among Adults Receiving Mental Health Treatment.","authors":"Orrin D Ware, Kerry A Lee, Brianna Lombardi, Daniel L Buccino, Jamey J Lister, Eunsong Park, Kate Roberts, Anthony Estreet, Tonya Van Deinse, Hannah Neukrug, Amy Blank Wilson, Daejun Park, Paul Lanier","doi":"10.1080/15504263.2024.2357623","DOIUrl":"10.1080/15504263.2024.2357623","url":null,"abstract":"<p><p><b>Objective:</b> The co-occurrence of anxiety disorders, depressive disorders, and substance use problems was examined. <b>Methods:</b> The Mental Health Client-Level Data dataset was used to conduct logistic regression models and an artificial neural network analysis. Logistic regression analyses were conducted among adults with anxiety (<i>n</i> = 547,473) or depressive disorders (<i>n</i> = 1,610,601) as their primary diagnosis who received treatment in a community mental health center. The artificial neural network analysis was conducted with the entire sample (<i>N</i> = 2,158,074). <b>Results:</b> Approximately 30% of the sample had co-occurring high-risk substance use or substance use disorder. Characteristics including region of treatment receipt, age, education, gender, race and ethnicity, and the presence of co-occurring anxiety and depressive disorders were associated with the co-occurring high-risk substance use or a substance use disorder. <b>Conclusions:</b> Findings from this study highlight the importance of mental health facilities to screen for and provide integrated treatment for co-occurring disorders.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155552","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":"Racial Microaggressions Mediate the Association Between Posttraumatic Stress and Alcohol Use Among Women of Color Experiencing Intimate Partner Violence","authors":"Silvi C. Goldstein, Shannon R. Forkus, Natalie Q. Fenn, Emmanuel D. Thomas, Nazaret C. Suazo, Nicole H. Weiss","doi":"10.1080/15504263.2024.2336629","DOIUrl":"https://doi.org/10.1080/15504263.2024.2336629","url":null,"abstract":"Objective: Women of Color (WoC) experiencing intimate partner violence (IPV) have elevated rates of posttraumatic stress disorder (PTSD) and alcohol use and related harm (e.g., increased alcohol us...","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"50 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588905","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":"Impact of Depressive Symptom Severity on Buprenorphine/Naloxone and Methadone Outcomes in People With Prescription-Type Opioid Use Disorder: Results From a Pragmatic Randomized Controlled Trial","authors":"Gabriel Bastien, Anita Abboud, Christina McAnulty, Laurent Elkrief, Omar Ledjiar, M. Eugenia Socias, Bernard Le Foll, Anees Bahji, Suzanne Brissette, Stéphanie Marsan, Didier Jutras-Aswad","doi":"10.1080/15504263.2024.2329267","DOIUrl":"https://doi.org/10.1080/15504263.2024.2329267","url":null,"abstract":"To evaluate the impact of depressive symptom severity on opioid use and treatment retention in individuals with prescription-type opioid use disorder (POUD).We analyzed data from a multi-centric, p...","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"59 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589279","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}