Advances in Dual Diagnosis最新文献

{"title":"Locked down and drinking? Are more people self-identifying as having mental health difficulties alongside their drinking via an online platform?","authors":"Angela Calcan, Mark Holmes","doi":"10.1108/ADD-02-2021-0005","DOIUrl":"https://doi.org/10.1108/ADD-02-2021-0005","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to offer a viewpoint on the impact that the COVID-19 pandemic has had on people’s engagement with an online alcohol service in the UK. This paper examines whether self-reported mental health concerns increased during the pandemic compared to pre-pandemic times.\u0000\u0000\u0000Design/methodology/approach\u0000A comparison was made between service data captured in one contract area – West Sussex, England – pre-pandemic (April 2019 to March 2020) and during pandemic (April 2020 to March 2021).\u0000\u0000\u0000Findings\u0000Self-reported mental health treatment needs increased during the pandemic period (71.2% of presentations compared to 50% pre-pandemic) via the online coaching service. Male referrals increased by 74% during the pandemic period compared to the previous year. Female referrals decreased by 4% in the same time period. Feelings of shame and guilt as well as loss of a confidential space to engage in online interventions were common concerns reported by service users.\u0000\u0000\u0000Research limitations/implications\u0000Research limitations include the relatively small sample size, the sample comprised of self-referred treatment seeking clients, and there was no control group. All data collected is self-report therefore subjective and not necessarily meeting diagnostic criteria.\u0000\u0000\u0000Practical implications\u0000Of note was the impact of the pandemic on women and their reduced access to the online service during the pandemic. Commissioners and services must adapt their service design and delivery alongside the new “normal” way of living and working. Routine screening of mental health and alcohol use are recommended.\u0000\u0000\u0000Originality/value\u0000This paper offers insight from an established online/digital service and the impact of the pandemic on people’s engagement with the service.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"1 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90870500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers for homeless with dual diagnosis: lessons learned from intensive mobile psychosocial assertive community treatment program","authors":"T. Zolnikov, Michaele M Hammel, Frances Furio, Brandon Eggleston","doi":"10.1108/add-09-2020-0019","DOIUrl":"https://doi.org/10.1108/add-09-2020-0019","url":null,"abstract":"\u0000Purpose\u0000Dual diagnosis is a term that describes the co-occurrence of mental health disorders or illness and substance use or abuse disorders. Because this co-occurrence results in multiple diseases, layers of treatment are often needed to successfully create positive change in the individual. The purpose of this study is to explore factors of treatment that could facilitate improvements in functionality and quality of life for those with a dual diagnosis.\u0000\u0000\u0000Design/methodology/approach\u0000A secondary data analysis, using both quantitative and qualitative data, was completed. Secondary analysis is an empirical exercise that applies the same basic research principles as studies using primary data and has steps to be followed, including the evaluative and procedural steps commonly associated with secondary data analysis. Documentation data from the intensive mobile psychosocial assertive community treatment program was gathered for this analysis; this program was used because of the intensive and community-based services provided to patients with a dual diagnosis.\u0000\u0000\u0000Findings\u0000The major findings from this secondary analysis suggested that significant barriers included “denial” (e.g. evasion, suspension or avoidance of internal awareness) of diagnoses, complicated treatment and other barriers related to housing. Ultimately, these findings provided greater insight into potential effective treatment interventions for people living with a dual diagnosis.\u0000\u0000\u0000Originality/value\u0000This study adds to the growing body of literature showing that patient-centered care allows for more effective treatment and ultimately, improved health outcomes.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"9 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76204798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"News, guidance and resources related to dual diagnosis in older adults","authors":"R. Rao","doi":"10.1108/ADD-05-2021-046","DOIUrl":"https://doi.org/10.1108/ADD-05-2021-046","url":null,"abstract":"","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"7 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73517311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated treatment of dual disorders in The Netherlands: a qualitative study of client experiences","authors":"A. V. Wamel, A.L.F. Lempens, A. Neven","doi":"10.1108/ADD-12-2020-0029","DOIUrl":"https://doi.org/10.1108/ADD-12-2020-0029","url":null,"abstract":"\u0000Purpose\u0000Many clients who suffer from severe mental health problems also struggle with alcohol and drug use. And although there seems to be a consensus in most European countries that integrated treatment models (especially the integrated treatment of dual disorder clients model) are best fitted to help these clients, none of these have strong evidence, mostly owing to methodological limitations in the studies. This study aims to contribute to the knowledge of why integrated treatment is helpful by conducting in-depth interviews with dual disorder clients who are currently receiving integrated treatment.\u0000\u0000\u0000Design/methodology/approach\u0000This study is a qualitative thematic analysis using a timeline tool to elicit participants’ responses. In the interviews, dual diagnosis clients with severe problems reflected on their situation at admission, the care they received in integrated treatment and their opinions on positive and negative elements. The interviews were coded and analysed with MAXQDA.\u0000\u0000\u0000Findings\u0000In the analyses of the interviews, this study found three clusters of elements that clients indicated were the most helpful during their treatment and recovery process: trusting and meaningful relationship with the team, components of integrated treatment and organisation of care.\u0000\u0000\u0000Originality/value\u0000The findings emphasized the importance of working relationship in the treatment of complex and long-term problems. This has implications for the evaluation of these integrated treatment models which so far mainly focuses on specific interventions.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"45 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85109726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The workplace culture in addiction psychiatry in Finland as described by healthcare personnel","authors":"Eeva Lyyra, M. Roos, T. Suominen","doi":"10.1108/ADD-11-2020-0024","DOIUrl":"https://doi.org/10.1108/ADD-11-2020-0024","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to describe the workplace culture and factors associated with it from the viewpoint of the personnel providing care to patients with dual diagnosis.\u0000\u0000\u0000Design/methodology/approach\u0000Data were collected from six organizations using an electronic survey in 2019. The respondents (n = 75) worked in addiction psychiatry in specialized health care and provided care to patients. The data were statistically analyzed.\u0000\u0000\u0000Findings\u0000Workplace culture was evaluated as positive. Stress was experienced occasionally (Md = 2.58, Q1 = 1.96, Q3 = 3.03), job satisfaction levels were moderate (Md = 4.83, Q1 = 4.28, Q3 = 5.44) and the practice environment was evaluated as neutral (Md = 4.46, Q1 = 4.00, Q3 = 5.04). Gender, age in years, employment relationship, work time, staffing, number of patients and the participants’ experience in health care and experience in their current workplace had statistically significant associations with workplace culture.\u0000\u0000\u0000Originality/value\u0000In Finland, there have been attempts to reform service structures that also influence mental health and substance addiction services. Workplace culture is one approach to promote service development. Yet, there has been no research on workplace culture in the context of the care of patients with dual diagnosis. The results of this study bring knowledge about how health-care personnel perceives stress, job satisfaction and their practice environment in addiction psychiatry, which can be used to further develop services and workplace culture.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"89 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82231443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric severity and stress among recovery home residents utilizing medication assisted treatment: a moderated mediation analysis of homophily","authors":"John M. Majer, Ted J. Bobak, L. Jason","doi":"10.1108/ADD-07-2020-0011","DOIUrl":"https://doi.org/10.1108/ADD-07-2020-0011","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to examine the relationship between psychiatric severity and stress among persons utilizing medication assisted treatment (MAT), and there is a need to identify resources that promote resilience against these risk factors. Although recovery homes might complement pharmacological interventions for persons using MAT, a lack of homophily (e.g. similar experiences) among residents could produce stress and increase psychiatric severity. The purpose of this paper is to examine stress and psychiatric severity in relation to recovery outcomes, and whether homophily moderated these relationships.\u0000\u0000\u0000Design/methodology/approach\u0000A cross-sectional analysis was conducted among recovery home residents who were recruited from the USA, including those using (n = 40) and not using (n = 132) MAT. Participants’ levels of psychiatric severity, stress, abstinence self-efficacy and quality of life were assessed in addition to whether residents using MAT were living with at least one other resident who used MAT. Moderated mediation analyses were conducted to examine whether homophily among residents using MAT would moderate the mediating effects of stress on the relationships between psychiatric severity and recovery outcomes (abstinence-self efficacy, quality of life).\u0000\u0000\u0000Findings\u0000Mediating effects were observed but they were significant only through homophily. Although stress increased the negative effects of psychiatric severity among residents using MAT, significantly lesser effects were observed among those living with residents using MAT.\u0000\u0000\u0000Practical implications\u0000Although psychiatric (problem) severity and stress threaten recovery for persons with substance use disorders, little is known how they impact recovery among those living in community-based settings such as recovery homes. In addition, there is a need to identify community resources that would complement MAT protocols, as patients who use MAT face unique stressors related to their sense of shared interests and experiences (i.e. homophily) when developing social bonds with others in recovery.\u0000\u0000\u0000Social implications\u0000This study suggests the social networks within recovery homes reduce the effects of psychiatric severity and stress, and that these effects are lessened for residents who use MAT when they live with others who also use MAT.\u0000\u0000\u0000Originality/value\u0000Little is known about recovery home residents who use MAT and have high psychiatric severity. Findings suggest homophily among persons using MAT living in recovery homes who have high psychiatric severity can promote resilience.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"124 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85977587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of rash-impulsivity, emotional dysregulation and reward drive in comorbid disordered eating and substance use disorders","authors":"Natalie Merinuk, Stephan Varcoe, P. Kelly, Laura D. Robinson","doi":"10.1108/ADD-01-2021-0002","DOIUrl":"https://doi.org/10.1108/ADD-01-2021-0002","url":null,"abstract":"\u0000Purpose\u0000Substance use disorder (SUD) frequently co-occurs with other psychological conditions, such as eating disorders (EDs). Psychological factors such as emotional dysregulation, rash impulsivity (RI) and reward sensitivity (RS) play a role in the etiology of each disorder, yet little is known about the combined effects of these on comorbid SUDs and EDs or disordered eating behaviours (DEBs). This study aims to examine the role of these psychological factors in comorbid DEBs and SUDs among individuals in treatment for SUDs. The role of gender is tested as a moderator.\u0000\u0000\u0000Design/methodology/approach\u0000A cross-sectional self-report survey was completed by 131 participants attending Australian residential substance use treatment centres. A binomial logistic regression analysis was performed to examine the effects of emotional dysregulation, RI and RS on comorbid DEB and SUD. Further, moderation analyses were used to examine the moderating effect for gender on the relationship between these three personality variables and comorbidity.\u0000\u0000\u0000Findings\u0000The most commonly reported primary substance of use was alcohol (43.5%), followed by amphetamines (38.6%). Findings showed that emotional dysregulation and RI were significantly related to an increase in comorbidity likelihood; however, RS was not. Gender moderated the relationship between comorbidity and RI only.\u0000\u0000\u0000Originality/value\u0000The significant positive relationship found between RI and comorbidity for females only was a novel finding for the current study. Further research is needed to develop an understanding of the etiology of comorbidity.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"1 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85295078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive impairment and treatment outcomes amongst people attending an alcohol intervention service for those aged 50+","authors":"J. Seddon, S. Wadd, L. Elliott, I. Madoc-Jones","doi":"10.1108/ADD-02-2021-0003","DOIUrl":"https://doi.org/10.1108/ADD-02-2021-0003","url":null,"abstract":"\u0000Purpose\u0000No studies have evaluated the relationship between cognitive impairment and alcohol treatment outcomes amongst older drinkers. This study aims to explore the extent of cognitive impairment amongst older adults seeking alcohol treatment and examine the relationship between cognitive impairment, treatment retention and alcohol use following treatment.\u0000\u0000\u0000Design/methodology/approach\u0000The study used data from the Drink Wise Age Well programme; an alcohol intervention service for older adults (aged 50+). The Montreal Cognitive Assessment was used to screen for cognitive impairment; alcohol use was assessed using the alcohol use disorders identification test.\u0000\u0000\u0000Findings\u0000In total, 531 participants completed the assessment at treatment entry. Over half the sample were male (57%), with a mean age of 60 years (Standard deviation: 7.09). Almost half (48.4%) had cognitive impairment at the entry to treatment: 51.6% had a normal cognitive function, 41.4% had mild cognitive impairment, 5.8% had moderate cognitive impairment and 1.1% had severe cognitive impairment. Cognitive impairment was not associated with increased treatment drop-out and was not predictive of alcohol use following treatment. Alcohol treatment was associated with a significant improvement in cognitive functioning.\u0000\u0000\u0000Originality/value\u0000This study suggests there may be a significant amount of unidentified cognitive impairment amongst older adults attending alcohol treatment. Assessment and routine screening for cognitive impairment in drug and alcohol services may help in care planning and setting treatment goals; in the absence of routine screening opportunities for treatment planning and intervention may be missed.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"106 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80743784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual diagnosis in older drinkers during the COVID-19 pandemic","authors":"R. Rao, C. Mueller, M. Broadbent","doi":"10.1108/ADD-12-2020-0028","DOIUrl":"https://doi.org/10.1108/ADD-12-2020-0028","url":null,"abstract":"Purpose: There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use. Design/methodology/approach: Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders. Findings: In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005). Research limitations/implications: The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers. Originality/value: A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic. © 2021, Emerald Publishing Limited.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"1 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83691879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of occupational meaningfulness and citizenship as mediators between occupational status and recovery: a cross-sectional study among residents with co-occurring problems","authors":"Linda Nesse, G. Aamodt, M. T. Gonzalez, M. Rowe, R. K. Raanaas","doi":"10.1108/ADD-08-2020-0018","DOIUrl":"https://doi.org/10.1108/ADD-08-2020-0018","url":null,"abstract":"\u0000Purpose\u0000Engagement in meaningful occupations and being included as full citizens of the community, is essential in everyday life, and may be of considerable relevance for recovery and quality of life. However, persons with co-occurring substance use and mental health problems experience extensive obstacles to engagement in occupations and citizenship. The relationship between objective measures of occupational status and subjective experiences of occupational meaningfulness, citizenship and recovery, is scarcely researched in the context of co-occurring problems. As such, the purpose of this study is to examine associations between occupational status, occupational meaningfulness, citizenship and recovery and quality of life and to examine the roles of occupational meaningfulness and citizenship as possible mediators between occupational status and recovery and quality of life.\u0000\u0000\u0000Design/methodology/approach\u0000The study used a cross-sectional design with a sample of 104 residents at supported housing sites across six Norwegian cities.\u0000\u0000\u0000Findings\u0000Linear regression analyzes indicated that occupational status was significantly associated with the citizenship domains caring for others and community participation and with the quality of life measure positive affect. Occupational meaningfulness and citizenship were significantly associated with different domains of recovery and quality of life. Furthermore, mediation analyzes showed that the relationship between occupational status and recovery and quality of life was mediated by caring for others and community participation.\u0000\u0000\u0000Originality/value\u0000The results suggest that emphasizing opportunities for occupational meaningfulness and citizenship in practice may have positive implications for recovery among persons with co-occurring problems.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"3 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79872180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}