Journal of Dual Diagnosis最新文献

{"title":"Changes in Alcohol Consumption following Direct-Acting Antiviral Treatment for Hepatitis C in VA Patients with Comorbid Alcohol Use Disorder and PTSD.","authors":"Jessica E Hoyt, Nikhil Teja, Tammy Jiang, Luke Rozema, Jiang Gui, Bradley V Watts, Brian Shiner, Jaimie L Gradus","doi":"10.1080/15504263.2022.2123119","DOIUrl":"10.1080/15504263.2022.2123119","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether direct-acting antivirals (DAA) for hepatitis C viral infection (HCV): glecaprevir/pibrentasvir (GLE/PIB), ledipasvir/sofosbuvir (LDV/SOF), and sofosbuvir/velpatasvir (SOF/VEL) are associated with reduced alcohol consumption among veterans with alcohol use disorder (AUD) and co-occurring post-traumatic stress disorder (PTSD).</p><p><strong>Methods: </strong>We measured change in Alcohol Use Disorder Identification Test-Consumption Module (AUDIT-C) scores in a retrospective cohort of veterans with PTSD and AUD receiving DAAs for HCV.</p><p><strong>Results: </strong>One thousand two hundred and eleven patients were included (GLE/PIB <i>n</i> = 174, LDV/SOF <i>n</i> = 808, SOF/VEL <i>n</i> = 229). Adjusted frequencies of clinically meaningful improvement were 30.5% for GLE/PIB, 45.5% for LDV/SOF, and 40.5% for SOF/VEL. The frequency was lower for GLE/PIB than for LDV/SOF (<i>OR</i> = 0.59; 95% CI [0.40, 0.87]) or SOF/VEL (<i>OR</i> = 0.66; 95% CI [0.42, 1.04]).</p><p><strong>Conclusions: </strong>DAA treatment for HCV was associated with a substantial reduction in alcohol use in patients with AUD and co-occurring PTSD. Further exploration of the role of DAAs in AUD treatment is warranted.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 4","pages":"185-198"},"PeriodicalIF":2.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719291/pdf/nihms-1848219.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10411118","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":"Interpersonal Violence, PTSD, and Substance Use Types among Women Receiving Substance Use Treatment.","authors":"Nada M Goodrum,&nbsp;Donte L Bernard,&nbsp;Angela D Moreland","doi":"10.1080/15504263.2022.2090649","DOIUrl":"https://doi.org/10.1080/15504263.2022.2090649","url":null,"abstract":"<p><p><b>Objective:</b> Many women receiving substance use treatment report histories of interpersonal violence (IV) victimization, including physical and sexual assault. IV is a risk factor for mental and behavioral health difficulties such as posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Consistent with the self-medication hypothesis, PTSD may explain elevated SUD among IV survivors. Yet, few studies have investigated whether PTSD may have differential mediating effects for different substances, which has significant treatment implications. <b>Methods:</b> In 124 women (<i>M</i> age = 35.37, <i>SD =</i> 11.90) in substance use treatment, we examined PTSD symptoms as a mediator between IV and severity of different types of substance use, including alcohol, cannabis, cocaine, and opioid use. Participants completed self-report measures including the ASSIST, PCL-5, and LEC-5. Data were analyzed using path analysis in Mplus 8.3. Both dichotomous and continuous outcomes of problematic substance use outcomes were examined. <b>Results:</b> Most women (53.3%) reported problematic substance use with at least one substance, including opioids (39.7%), cocaine (13.0%), alcohol (9.6%), and cannabis (5.6%). Most (83.2%) of the sample reported at least one IV incident. On average, women reported clinically significant PTSD symptom severity. When problematic substance use was examined dichotomously, findings revealed significant indirect effects from IV exposure to opioid (<i>β</i> = 0.10, <i>p =</i> .010) and cocaine use (<i>β</i> = 0.07, <i>p =</i> .039) via elevated PTSD symptoms. There were no significant indirect effects for problematic alcohol (<i>β</i> = 0.03, <i>p =</i> .260) or cannabis use (<i>β</i> = 0.02, <i>p</i> = .562). When substance use was examined continuously, results revealed significant indirect effects from IV exposure to opioid (<i>β</i> = 0.09, <i>p =</i> .017), cocaine use (<i>β</i> = 0.09, <i>p =</i> .015), and alcohol use (<i>β</i> = 0.08, <i>p =</i> .020) via elevated PTSD symptoms. Indirect effects for cannabis use remained nonsignificant (<i>β</i> = 0.05, <i>p = .</i>100). <b>Conclusions:</b> IV survivors may be particularly at risk for opioid and cocaine misuse because of elevated PTSD symptoms. Treatments that integrate PTSD and SUD are needed to simultaneously target traumatic stress and substance use. Women with opioid and cocaine misuse may particularly benefit from trauma-focused exposure-based psychotherapy to reduce symptoms of PTSD, and thus, decrease opioid and cocaine misuse.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 3","pages":"123-134"},"PeriodicalIF":2.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9721397/pdf/nihms-1848217.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817514","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":"Implementing Chronic Care Model Treatments for Cigarette Dependence in Community Mental Health Clinics.","authors":"Sandra J Japuntich, Melissa Adkins-Hempel, Carina Lundtvedt, Sara J Becker, Sarah A Helseth, Steven S Fu, Jennifer Tidey, A Eden Evins, Rebekah Pratt","doi":"10.1080/15504263.2022.2090647","DOIUrl":"10.1080/15504263.2022.2090647","url":null,"abstract":"<p><p><b>Objective:</b> Tobacco use is rarely addressed in community mental healthcare settings, despite its high prevalence among people with serious mental illness. The aim of the current study was to gather stakeholder feedback regarding the feasibility of chronic care management strategies for tobacco dependence in community mental health centers (CMHCs). Chronic care strategies evaluated included the 5 As (Ask about tobacco use, Advise users of tobacco to quit, Assess interest in cessation, Assist with cessation, and Arrange for follow-up) and proactive telephone outreach (reaching out to all users of tobacco to offer connection to tobacco cessation treatment). <b>Methods:</b> Using a semi-structured interview guide informed by the Practical Robust Implementation and Sustainability Model, we conducted individual semi-structured interviews with providers, leaders, and clients across two CMHCs. Our objectives were to capture their attitudes toward smoking cessation treatment, two chronic care model interventions (i.e., proactive outreach, the 5 As), and to determine the infrastructure needed to implement such interventions in their CMHCs. Thematic analysis was conducted by two independent coders to uncover pertinent themes. <b>Results:</b> Participants (<i>n</i> = 20) included nine providers, six leaders, and five clients. Thematic analysis revealed three major themes: (1) characteristics of recipients, (2) characteristics of the intervention, and (3) infrastructure needed for implementation and sustainability. Providers, leaders, and clients all reported that tobacco cessation treatment was rarely provided in CMHCs and expressed an interest in such treatments becoming more available. The 5 As and proactive outreach were viewed as feasible and acceptable to deliver and receive. Providers, leaders, and clients wanted support to connect clients with smoking cessation treatment. Providers and leaders requested a range of implementation supports, including didactic trainings, decision aids, performance feedback, and coaching on evidence-based tobacco cessation treatments for people with serious mental illness. Clients requested tobacco cessation resources, such as a cessation counseling provided at the CMHC and prescriptions for cessation medication. <b>Conclusions:</b> CMHC providers, leaders, and clients are interested in making tobacco cessation services more widely accessible and available. The feedback gathered in this study can be used to inform the delivery and implementation of guideline-adherent tobacco dependence care in CMHCs.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 3","pages":"153-164"},"PeriodicalIF":2.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472099/pdf/nihms-1831822.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10091256","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":"Trends in Psychiatric Hospitalizations of Patients With Dual Diagnosis in Spain","authors":"Carlos Gómez-Sánchez-Lafuente, J. Guzmán-Parra, J. Suarez-Perez, A. Bordallo-Aragon, Fernando Rodriguez-de-Fonseca, F. Mayoral-Cleríes","doi":"10.1080/15504263.2022.2053770","DOIUrl":"https://doi.org/10.1080/15504263.2022.2053770","url":null,"abstract":"Abstract Objective Substance use disorders are highly prevalent in people living with a mental health disorder. Co-occurring substance use disorders have been associated with a worse prognosis and poorer adherence to treatment. The aim of this study was to analyze the temporal trends in the prevalence of substance use disorders in patients admitted to a psychiatric inpatient unit between 1998 and 2020. Methods This is a retrospective study based on the registry of 18,367 hospitalizations and 7,124 patients with a mental health disorder admitted during the period 1998 to 2020 in Malaga, Spain. Time trend analysis by gender and substance used was calculated using a segmented regression model. The permutation test was used to determine inflection points. A sensitivity analysis was performed based on the assumptions of autocorrelation and homoscedasticity. Results A total of 22.2% of admissions had a diagnosis of mental health disorder and co-occurring substance use disorders. Prevalence was higher among males (30.0%) than females (9.4%; p < .001). Patients with both disorders had a shorter length of stay by 2 days (p < .001) and a younger age at first admission (by 6.5 years; p < .001) compared to patients without substance use disorders. There was no difference in the total number of hospitalizations between the two groups. Psychotic disorders and multiple drug use disorders were the most prevalent diagnoses in men compared to women, whereas personality disorders and alcohol use were the most common diagnoses in women. We observed an increase in the prevalence of dual diagnosis between 2005 and 2020. There was a 3.0% increase in cannabis-related admissions per year during the whole study period (p < .001). Cannabis and cocaine use disorders have become the most prevalent in the last 10 years, while opioid and alcohol use disorders have decreased. Conclusions Co-occurring substance use disorders are highly prevalent among hospitalized patients. In recent years, the pattern of substance use has shifted, with cannabis being the most prevalent, while opiates and alcohol substance use have decreased. We need to devise a specialized approach and integrative treatment for patients with co-occurring disorders.","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"342 1","pages":"92 - 100"},"PeriodicalIF":2.2,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76387111","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":"Wait No Longer: Reducing Medication Wait-Times for Individuals with Co-Occurring Disorders.","authors":"James H Ford, Deepika Rao, Aaron Gilson, Arveen Kaur, Helene Chokron Garneau, Lisa Saldana, Mark P McGovern","doi":"10.1080/15504263.2022.2052225","DOIUrl":"10.1080/15504263.2022.2052225","url":null,"abstract":"<p><p><b>Objective:</b> Community addiction treatment agencies have utilized Network for the Improvement of Addiction Treatment (NIATx), a proven implementation strategy, to reduce appointment wait-times. However, its effectiveness at reducing medication access wait-times has not been explored. Thus, we conducted an exploratory analysis to evaluate the impact of the NIATx implementation strategies on reduced wait-times to addiction, psychotropic or both medications for individuals with co-occurring disorders (COD). <b>Methods:</b> In a cluster-randomized waitlist control group design, community addiction treatment agencies (<i>n</i> = 49) were randomized to receive the NIATx strategy (Cohort 1, <i>n</i> = 25) or to a Waitlist control (Cohort 2, <i>n</i> = 24). All agencies had a 12-month active intervention period. The primary outcome was the medication encounter wait-time. A univariate general linear model analysis utilizing a logarithmic (log10) transformation examined medication wait-times improvements. <b>Results:</b> The intent-to-treat analysis for psychotropic medications and both medications (reflecting integrated treatment) showed significant main effects for intervention and time, especially comparing Baseline and Year 1 to Year 2. Conversely, only the main effect for time was significant for addiction medications. Wait-time reductions in Cohort 1 agencies was delayed and occurred in the sustainment phase. Wait-times to a psychotropic, addiction, or both medications encounter declined by 3 days, 4.9 days, and 6.8 days, respectively. For Cohort 2 agencies, reduced wait-times were seen for psychotropic (3.4 days), addiction (6 days), and both medications (4.9 days) during their active implementation period. Same- or next-day medication access also improved. <b>Conclusions:</b> NIATx implementation strategies reduced medication encounter wait-times but timing of agency improvements varied. Despite a significant improvement, a three-week wait-time to receive integrated pharmacological interventions is clinically suboptimal for individuals with a COD in need of immediate intervention. Community addiction treatment agencies should identify barriers and implement changes to improve medication access so that their patients \"wait no longer\" to receive integrated treatment and medications for their COD.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 2","pages":"101-110"},"PeriodicalIF":2.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503325/pdf/nihms-1834974.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9258229","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":"Multimodal Correlates of Cannabis Use among U.S. Veterans with Bipolar Disorder: An Integrated Study of Clinical, Cognitive, and Functional Outcomes.","authors":"Alexandria Selloni,&nbsp;Gagandeep Bhatia,&nbsp;Mohini Ranganathan,&nbsp;Joao P De Aquino","doi":"10.1080/15504263.2022.2053264","DOIUrl":"https://doi.org/10.1080/15504263.2022.2053264","url":null,"abstract":"<p><p><b>Objective:</b> Cannabis use (CU) is common among persons with bipolar disorder (BD). Evidence suggests that CU is associated with poorer outcomes among persons with BD; however, these findings remain inconsistent. The present exploratory study aims to examine clinical, functional, and cognitive correlates of CU among persons with BD. <b>Methods:</b> U.S. veterans with BD type I who participated in a large-scale, nationwide study were categorized into four groups: current CU, past CU, past other drug use, and no drug use. Bivariate analyses, univariate analyses of covariance, and Levene's Test for Equality of Variance were used to compare groups on clinical, cognitive, and functional measures. <b>Results:</b> Of 254 (84.6% male) veterans with BD type I included in the analyses, 13 (5.1%) had current CU, 37 (14.5%) past CU, 77 (30.3%) past other drug use, and 127 (50%) reported no drug use. BD with CU was associated with post-traumatic stress disorder (PTSD) and experiencing lifetime suicidal ideation. Notably, current CU was associated with higher working memory performance, compared to both past CU and no drug use. Likewise, current CU was associated with higher functional capacity, compared to past CU as well as no drug use. <b>Conclusions:</b> These findings contribute to the growing literature on the complex effects of cannabis on BD. As the commercialization and legalization of cannabis increases, further research in this area is warranted to quantify posed risks to this population, and thereby guide clinical decision-making.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 2","pages":"81-91"},"PeriodicalIF":2.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794455/pdf/nihms-1848210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10535797","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":"REDD-PAC Cohort Description: Researching Dual Diagnosis – Prognosis and Characteristics","authors":"Solvej Mårtensson, K. Johansen, J. Krarup, Signe W During","doi":"10.1080/15504263.2022.2055250","DOIUrl":"https://doi.org/10.1080/15504263.2022.2055250","url":null,"abstract":"Abstract Objective Evidence from real-world integrated dual diagnosis treatment programs is limited. In 2017 we decided to establish the REDD-PAC cohort with the aim to provide more in-depth information regarding the effect of integrated treatment. Methods The REDD-PAC cohort includes more than 2,500 patients with dual diagnosis that have been treated at an in-patient department specializing in the integrated treatment of both psychiatric illness and substance use disorder in Denmark in the period from 2002 to 2017. The collected data included information on diagnosis as well as patient-completed questionnaires regarding anxiety, depression, self-worth, and use of substances. Data regarding medications prescribed and administered, weight, height, and blood pressure were also included. Results The primary diagnosis was psychosis spectrum disorder (37.0%), followed by affective disorders (18.8%). More than two-thirds of the patients were male, and most patients had a weak connection to the labor market and basic schooling. Patients were generally very motivated for treatment. Conclusions Further linking the data to Danish national register data makes it possible to follow individual trajectories pre- and post-admission as well as to access complete follow-up data regarding long-term outcomes, e.g., use of health services, mortality, morbidity, crime, and social circumstances. This article describes both the overarching aims of the REDD-PAC cohort and the basic diagnostic and sociodemographic characteristics of the cohort.","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"30 1","pages":"111 - 122"},"PeriodicalIF":2.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81982877","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":"Reviewers for Journal of Dual Diagnosis","authors":"","doi":"10.1080/15504263.2022.2022299","DOIUrl":"https://doi.org/10.1080/15504263.2022.2022299","url":null,"abstract":"","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"3 1","pages":"(70) - (70"},"PeriodicalIF":2.2,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79840529","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":"Differential Predictors of Suicidal Ideation and Suicide Attempts: Internalizing Disorders and Substance Use in a Clinical Sample of Adolescents.","authors":"Lauren M Berny,&nbsp;Emily E Tanner-Smith","doi":"10.1080/15504263.2021.2016343","DOIUrl":"https://doi.org/10.1080/15504263.2021.2016343","url":null,"abstract":"<p><p><b>Objective:</b> Dually diagnosed adolescents are a high-risk population for experiencing suicidal thoughts and behavior. Given that research suggests risk factors for suicidal ideation and suicide attempts may be different, this study examined whether internalizing disorder severity, frequency of substance use, and the interaction between them differentiated adolescents who attempted suicide from those who ideated. <b>Methods:</b> Baseline data from 287 adolescents who received formal substance use disorder (SUD) treatment were used in this analysis. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) severity as well as past-3 month use of alcohol, cannabis, and other illicit drugs were considered. The outcome of interest was a three-category measure of suicide risk: no reported suicidal ideation or attempts, suicidal ideation only, and suicide attempts. <b>Results:</b> Over half of the sample disclosed prior suicidal ideation (30.0%) or attempts (27.9%). Multinomial logistic regression models indicated more severe MDD and GAD symptomology differentiated ideators from non-suicidal adolescents, but internalizing disorder severity did not differ between ideators and attempters. Substance use frequency did not differ between suicide risk groups. MDD severity and frequency of alcohol use interacted to increase the risk of attempts, yet the effects were minimal. Instead, prior weapon violence victimization and sexual abuse were the largest differentiators between attempters and ideators. <b>Conclusions:</b> Findings suggest that internalizing disorder severity and prior traumatic experiences put adolescents with SUD histories at higher risk of suicidal thoughts and behaviors. Thus, integrating evidence-based suicide prevention and intervention efforts into SUD treatment is critical, particularly for dually diagnosed adolescents who meet these risk profiles. Psychotherapy and medication may help curtail the development of ideation by reducing symptoms of MDD and GAD, whereas adolescents with prior traumatic experiences may benefit from additional treatments shown to lower risk of suicide attempts.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 1","pages":"59-69"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960344/pdf/nihms-1770857.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10484159","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":"Catatonic Episodes Related to Substance Use: A Cross-Sectional Study Using Electronic Healthcare Records.","authors":"Su Ying Yeoh,&nbsp;Emmert Roberts,&nbsp;Fraser Scott,&nbsp;Timothy R Nicholson,&nbsp;Anthony S David,&nbsp;Jonathan P Rogers","doi":"10.1080/15504263.2021.2016342","DOIUrl":"https://doi.org/10.1080/15504263.2021.2016342","url":null,"abstract":"<p><p><b>Objective:</b> Substance use has increasingly been linked to the onset of catatonic episodes; however, no large observational studies have examined this association. This study aimed to identify catatonic episodes temporally associated with acute intoxication, withdrawal or chronic substance use, investigate which substances were involved, and compare clinical characteristics of substance-related and non-substance-related catatonic episodes. <b>Methods:</b> This study retrospectively identified all catatonic episodes recorded in an electronic case register hosted at a large secondary mental health trust in London, UK. Episodes were categorized as substance-related if the clinical record reported either a positive urine drug screen, an ICD-10 diagnosis of a mental or behavioral disorder due to substance use, or documented substance use between two weeks prior to the catatonic episode and the date of the catatonic episode. <b>Results:</b> 108 of 2130 catatonic episodes (5.1%) were deemed substance-related. The number of contemporaneously reported substance-related episodes increased between 2007 and 2016 [<i>r</i> = 0.72, <i>p</i> = 0.02]. Episodes in the context of acute intoxication (<i>n</i> = 54) were most frequently related to cannabis (<i>n</i> = 31) or cocaine (<i>n</i> = 5) use, whilst those in the context of drug withdrawal (<i>n</i> = 8) were most commonly related to alcohol, opioids and benzodiazepines. There were 50 episodes of catatonia associated with chronic substance use without intoxication or withdrawal, of which the majority were related to cannabis use (<i>n</i> = 37). 21 episodes had overlapping intoxication, withdrawal and chronic use of different substances within an episode. Compared to catatonic episodes not related to substance use, episodes of substance-related catatonia occurred in individuals who were younger (mean age 31.3 years [SD 12.2] vs 35.7 years [SD 16.3], <i>p</i> = 0.01) and more likely to be men (74.0% vs 54.3%, <i>p</i> < 0.001). The clinical features of catatonia were similar between the two groups. <b>Conclusions:</b> A relatively small proportion of catatonic episodes were temporally associated with reported substance use within their electronic records. Substance-related catatonic episodes were mostly related to cannabis use, but other substances including cocaine, alcohol, opioids and benzodiazepines were sometimes implicated. This is likely an underestimate of substance-related catatonia use due to issues with documentation and appropriate investigation.</p>","PeriodicalId":46571,"journal":{"name":"Journal of Dual Diagnosis","volume":"18 1","pages":"52-58"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9106613","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}