Integrated mental health and substance abuse treatment within an assertive community treatment (ACT) approach was compared to that within a standard case management approach for 223 patients with dual disorders over three years. ACT patients showed greater improvements on some measures of substance abuse and quality of life, but the groups were equivalent on most measures, including stable community days, hospital days, psychiatric symptoms, and remission of substance use disorder.

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The validity of subtypes based on antisocial personality disorder (APD) or childhood conduct disorder without adult APD (CD only) in patients with schizophrenia (or schizoaffective disorder) and a substance use disorder (abuse or dependence) was examined. APD patients scored lower on personality measures related to socialization and higher on antisocial behavior, psychopathy, and aggression. APD patients also reported higher rates of aggression and legal problems. APD, and to a lesser extent CD only, was associated with more severe psychiatric symptoms, an earlier age of onset of substance abuse, more severe symptoms of substance abuse, and a stronger family history of substance abuse and psychiatric hospitalization. The findings suggest that schizophrenia patients with APD represent a high-risk subgroup vulnerable to more severe substance abuse, psychiatric impairment, aggression, and legal problems.

Few studies have explored correlates of antisocial personality disorder (ASPD) and psychopathy among individuals with severe mental illness and co-occurring substance use disorder. This study examined the reliability and validity of measures of ASPD and psychopathy among 203 clients with dual disorders and their prospective relationship to criminality and violence over 3 years. Except for the interpersonal/affective factor, the total Self-Report Psychopathy Scale (SRP-II) and antisocial lifestyle factor displayed good reliability and convergent validity with other measures of antisociality. SRP-II scores had limited associations with criminality and violence, whereas ASPD, thought disturbance, negative affect, and earlier age at psychiatric hospitalization were predictive of aggressive behavior. Further research on community violence should examine other measures of psychopathy as well as ASPD and symptoms.

Background-Millions of people seek emergency department care for injuries each year, the majority for minor injuries. Little is known about the effect of psychiatric co-morbid disorders that emerge after minor injury on functional recovery. This study examined the effect of post-injury depression on return to pre-injury levels of function.