Comorbid Addiction and Major Mental Illness in Europe: A Narrative Review

Carrà, Giuseppe; Bartoli, Francesco; Brambilla, Giulia; Crocamo, Cristina; Clerici, Massimo

doi:10.1080/08897077.2014.960551

Cited by 44 publications

(36 citation statements)

References 73 publications

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“…Several studies have shown, along with gender and age (e.g., Vieweg et al, 2009;Yang et al, 2011), the effects on QTc of other drugs, from multiple therapeutic classes, including antibiotics, tricyclic antidepressants, antihistamines, selective-serotonin reuptake inhibitors, and antiemetics (Beach et al, 2014;Woosley and Romero, 2015). Moreover, other factors potentially associated with QTc prolongation, such as alcohol intake (Zhang et al, 2011) and illicit substances misuse (Devlin and Henry, 2008), are highly prevalent among subjects suffering from mental disorders (Carrà et al, 2015). An extensive use of concurrent drugs due to poor physical health (e.g., Carrà et al, 2014;Clerici et al, 2014) and high rates of comorbid alcohol or substance abuse (Carrà et al, 2006) are common among people with severe mental illnesses.…”

Section: Introductionmentioning

confidence: 99%

First-generation antipsychotics and QTc: any role for mediating variables?

Carrà

Crocamo

Bartoli

et al. 2016

Hum. Psychopharmacol Clin Exp

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Section: Introductionmentioning

confidence: 99%

First-generation antipsychotics and QTc: any role for mediating variables?

Carrà

Crocamo

Bartoli

et al. 2016

Hum. Psychopharmacol Clin Exp

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“…Further, the evidence for the effectiveness of specific psychosocial interventions with this population is poor (Hunt et al, 2013). Research in the UK and internationally has concluded that the division between mental health and substance misuse services is problematic and has recommended that services become more holistic and integrated (Carrà et al 2015). Existing UK policy reflects this, with NICE guidance recommending that existing specialist services should be adapted to serve this population effectively (NICE, 2016).…”

Section: Introductionmentioning

confidence: 99%

Narratives of recovery in people with coexisting mental health and alcohol misuse difficulties

Stott

Priest

2018

ADD

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Purpose: Existing literature has examined what recovery means to people with co-occurring difficulties, but does little to examine experiences of recovery as a process. This paper uses a narrative approach to explore the process of recovery as an individual journey in a social context. It focusses on people who use alcohol in order to explore the impact of alcohol's specific cultural meanings on the recovery journey.Purpose: People with coexisting mental health and alcohol misuse difficulties face multiple disadvantages. The concept of recovery has become important for policy and practice in both mental health and alcohol misuse services. However, the recovery narratives of this population are under-represented in the literature. Methodology:Ten interviews with people with coexisting mental health and alcohol misuse difficulties were conducted, audio-recorded, and transcribed. The transcriptions were analysed using narrative analysis. Practical implications:The value placed on professionals having specialised therapeutic skills in working with trauma highlights the need for training in this area. The role for practical and material support underlines the importance of multi-agency working.

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“…The authors found that substance use disorders were strongly associated with risk of completed suicides and suicide attempts. The detrimental effect of co-occurring substance use disorders on mental disorder course was thus confirmed [2]. In particular, individuals with comorbid bipolar and substance use disorders were more likely to have a history of suicide attempt compared with their non-comorbid counterparts (23.2 versus 10.2%) [1].…”

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confidence: 62%

Commentary on Ostergaard et al. (2017): Evidence of an association between cannabis use and suicide in subjects with bipolar disorder

Bartoli

2017

Addiction

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Commentary on Ostergaard et al. (2017): Evidence of an association between cannabis use and suicide in subjects with bipolar disorder Comorbid cannabis use disorder may affect negatively the long-term outcomes of bipolar disorder. Although the direction of the association between cannabis use and bipolar symptoms needs to be clarified, there is now sufficient evidence to hypothesize a role of cannabis use in increasing the risk of suicide.The Danish nation-wide, prospective, register-based study by Østergaard et al. [1] tested associations between different substance use disorders and attempted or completed suicides in a large sample of individuals with severe mental illness (n = 35 625 with schizophrenia; n = 9279 with bipolar disorder; n = 72 530 with depression; and n = 63 958 with personality disorder). The authors found that substance use disorders were strongly associated with risk of completed suicides and suicide attempts. The detrimental effect of co-occurring substance use disorders on mental disorder course was thus confirmed [2]. In particular, individuals with comorbid bipolar and substance use disorders were more likely to have a history of suicide attempt compared with their non-comorbid counterparts (23.2 versus 10.2%) [1]. Results of this study are consistent with previous meta-analytic data [3] showing that rates of suicide attempts among subjects with bipolar and alcohol or substance use disorders are twofold higher than in subjects with bipolar disorder only.The relationship between cannabis and suicide in subjects with bipolar disorder is, however, worth further discussion, given that previous research exploring this topic has produced mixed results [3,4]. For example, it has been reported that approximately one-fifth of subjects with bipolar disorder, especially males with an earlier age of illness onset, misuse cannabis [5]. Cannabis use is associated with increased manic, depressive and psychotic symptoms [6,7], rapid cycling [8], low compliance [7] and poorer functioning [9], therefore affecting long-term clinical outcomes and decreasing the probability of remission [10]. Previous meta-analytic data [3,11], including four different studies [12][13][14][15] based on 3439 subjects with bipolar disorder (559 with comorbid cannabis use disorder), have shown a significant association [odds ratio (OR) = 1.44; 95% confidence interval (CI) = 1.07-1.94] between suicide attempts and cannabis use. Nevertheless, the small effect size, the wide confidence intervals and a partial inconsistency of results (a moderate heterogeneity across studies) all limit confidence in these findings. Moreover, the cross-sectional design of this meta-analysis has not permitted causal inferences of the relationship between suicide attempts and cannabis use disorder to be considered.Longitudinal analyses are now needed to explore the potential role of cannabis in increasing the risk of suicide among individuals with bipolar disorder. Findings from the prospective study by Østergaard et al. [1] showed that current canna...

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Comorbid Addiction and Major Mental Illness in Europe: A Narrative Review

Abstract: Integrated models implemented following US example might perform differently within the context of well-established European Union (EU) community mental health services. Such programs would require additional resources and radical redesign of service delivery systems.

Cited by 44 publications

References 73 publications

First-generation antipsychotics and QTc: any role for mediating variables?

First-generation antipsychotics and QTc: any role for mediating variables?

Narratives of recovery in people with coexisting mental health and alcohol misuse difficulties

Commentary on Ostergaard et al. (2017): Evidence of an association between cannabis use and suicide in subjects with bipolar disorder

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