Mental health versus substance abuse treatment programs for dually diagnosed patients

Primm, Annelle B.; Gomez, Marisela B.; Tzolova-Iontchev, Ilina; Perry, Walter; Vu, Hong Thi; Crum, Rosa M.

doi:10.1016/s0740-5472(00)00112-4

Cited by 41 publications

(29 citation statements)

References 27 publications

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“…Prior research has indicated that substance abusers with severe psychopathology are more likely to receive treatment at mental health facilities and those with less severe psychopathology are more likely to receive treatment at substance abuse facilities (Primm et al, 2000). However, current findings suggest that this conclusion based on prior research may not be generalizable to individuals in detoxification.…”

Section: Discussioncontrasting

confidence: 72%

Psychiatric symptomatology among individuals in alcohol detoxification treatment

Johnson

Brems

Mills

et al. 2007

Addictive Behaviors

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The coexistence of psychiatric symptomatology among individuals receiving longer-term treatment for alcohol use disorders has been well-established; however, less is known about comorbidity among individuals receiving alcohol detoxification. Using the Brief Symptom Inventory (BSI; Derogatis, 1992), we compared psychiatric symptomatology among 815 individuals receiving short-term detoxification services with normative data from nonpatients, psychiatric patients, and out-oftreatment individuals using street drugs. Findings revealed that individuals in the current sample reported a wide range of psychiatric symptoms with over 80% meeting BSI criteria for diagnosable mental illness. These BSI scores were significantly more severe than those reported by out-oftreatment individuals using street drugs and most closely resembled BSI scores reported for adult psychiatric inpatients. Findings suggest that routine screening for severe mental health symptoms appears warranted in detoxification units. Such screening would greatly increase the chance that coexistence of substance use and other psychiatric disorders would be properly addressed in ongoing treatment. Keywordspsychopathology; dual diagnosis; comorbidity; alcohol detoxification; alcoholism IntroductionAmple documentation exists that the co-occurrence of psychiatric disorders with substance use disorders is a general and widespread problem in general mental health and substance abuse treatment settings (e.g., Brems & Johnson, 2004;Havassy, Alvidrez & Owen, 2004;RachBeisel, Scott, & Dixon, 1999) Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Method Setting and ParticipantsData were collected from 815 individuals receiving services at an alcohol detoxification unit located in Anchorage, Alaska. This unit is designed to provide a four-day intervention to detoxify individuals from alcohol and to assess them for any additional needed treatment. Average length of stay for the participants was 4.84 days (SD=1.28). Table 1 provides demographic information about the 815 participants. InstrumentationBrief Symptom Inventory (BSI; Derogatis, 1992 Scoring is accomplished by adding ratings for subscale items and dividing by the number of items. These mean raw scores can be transformed into T-scores (mean of 50 and standard deviation of 10) separately for women and men, based on relevant norms tables (adult, adolescent, inpatient, and outpatient). The following two criteria have been established for designating a protocol as being positive for diagnosable psychopathology based on adult, nonpatient norms: a) T-sc...

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Section: Discussioncontrasting

confidence: 72%

Psychiatric symptomatology among individuals in alcohol detoxification treatment

Johnson

Brems

Mills

et al. 2007

Addictive Behaviors

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“…A maioria dos estudos utiliza o conceito de suporte/apoio social como fundamental ao tratamento de transtornos associados ao consumo de álcool e drogas. Outros tratam da relação entre "desordem mental" e consumo de álcool e drogas, demonstrando que indivíduos com desordem mental são prevalentes nos programas de tratamento para o abuso de substâncias (Compton et al, 2000;Havassy et al, 2004;Primm et al, 2000;Watkins et al, 2004).…”

Section: Discussão Dos Resultadosunclassified

A reabilitação psicossocial na atenção aos transtornos associados ao consumo de álcool e outras drogas: uma estratégia possível?

Pinho

Oliveira²,

Almeida³

2008

Rev. psiquiatr. clín.

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ResumoContexto: O consumo de álcool e drogas constitui-se em uma problemática mundial. A exclusão e a ausência de políticas específicas que marcaram a saúde pública brasileira demonstram a necessidade de reversão dos modelos assistenciais para contemplar as reais necessidades dos usuários que apresentam transtornos decorrentes do consumo de álcool e drogas. O desafio de formular uma política específica de prevenção, tratamento e reabilitação numa lógica que permita a singularidade e a reinserção social dos indivíduos tem sido tema dos diversos estudos nessa área. Objetivos: Identificar a utilização e compreensão do conceito da reabilitação psicossocial na atenção aos problemas associados ao consumo de álcool e drogas. Métodos: Revisão bibliográfica do banco de dados MEDLINE, de 1997 a 2007, sobre a reabilitação psicossocial no campo da atenção aos transtornos decorrentes do consumo de álcool e outras drogas. Resultados: Foram selecionados dez artigos que apresentavam similaridade com o tema. Conclusões: Encontramos os termos "suporte social" e "apoio social", que fazem referência à importância da rede social na recuperação do usuário de álcool e outras drogas, assim como a reabilitação psicossocial determina a importância da rede social do indivíduo como um de seus eixos. , P.H. et al. / Rev. Psiq. Clín 35, supl 1; 82-88, 2008 Palavras-chave: Reabilitação psicossocial, álcool, drogas. Pinho AbstractContext: The consumption of alcohol and drugs constitutes a worldwide problem. Exclusion and lack of specific policies for those who suffer with drug and alcohol dependency has marked Brazilian public health policy and demonstrated the need for change in the service models in order to contemplate the real needs of those with alcohol and drug abuse disorders. The challenge of formulating a specific prevention, treatment and rehabilitation policy within a framework that considers individuality and allows social reinsertion of individuals has been the subject of numerous studies in this area. Objectives: To identify the use and understanding of the concept of psychosocial rehabilitation associated with the problems of alcohol and drug abuse. Methods: Literature review in the MEDLINE database between 1997 and 2007 on psychosocial rehabilitation, specifically in the cases of alcohol and drug use disorders. Results: Ten articles were selected based on their pertinence to the subject. Conclusions: We found the term "social support" which refers to the importance of a social network to help the patient recovering from alcohol and drug addiction, just as the psychosocial rehabilitation -which determines the importance of the individual's social network -is one of its bases.Pinho, P.H. et al. / Rev. Psiq. Clín 35, supl 1; 82-88, 2008

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“…Substance abuse programs are increasingly called upon to provide treatment for individuals with co-occurring psychiatric disorders (68,69), particularly those with less severe mental disorders (70). Yet, at present, national survey data show that only about half of outpatient and residential substance abuse treatment providers offer specialized dual diagnosis services (71).…”

Section: Discussionmentioning

confidence: 99%

Impact of Program Services on Treatment Outcomes of Patients With Comorbid Mental and Substance Use Disorders

Grella¹,

Stein²

2006

Psychiatric Services

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Objective: This study examined the outcomes of individuals with co-occurring disorders who received drug treatment in programs that varied in their integration of mental health services. Patients treated in programs that provided more on-site mental health services and had staff with specialized training were expected to report less substance use and better psychological outcomes at follow-up. Methods:Participants with co-occurring disorders were sampled from 11 residential drug abuse treatment programs for adults in Los Angeles County. In-depth assessments of 351 patients were conducted at treatment entry and at follow-up six months later. Surveys conducted with program administrators provided information on program characteristics. Latent variable structural equation models revealed relationships of patient characteristics and program services with drug use and psychological functioning at follow-up.Results: Individuals treated in programs that provided specific dual diagnosis services subsequently had higher rates of utilizing mental health services over six months and, in turn, showed significantly greater improvements in psychological functioning (as measured by the Brief Symptom Inventory and the RAND Health Survey 36-item short form) at follow-up. More use of psychological services was also associated with less heroin use at follow-up. African Americans reported poorer levels of psychological functioning than others at both time points and were less likely to be treated in programs that provided mental health services. Conclusions:Study findings support continued efforts to provide specialized services for individuals with co-occurring disorders within substance abuse treatment programs as well as the need to address additional barriers to obtaining these services among African Americans.General population surveys and clinical studies have demonstrated that a majority of individuals with drug abuse problems have a co-occurring mental disorder (1-3). Individuals with co-occurring mental and substance use disorders have higher rates of treatment use compared with individuals with only one disorder (4-6), although most individuals with cooccurring disorders do not receive adequate treatment for either or both disorders (7-9). National survey data show that over half of adults with co-occurring disorders received neither substance abuse nor mental health treatment in the past year (10).Several studies have demonstrated that patients with serious mental disorders are prevalent within substance abuse treatment programs (ranging from about one-fifth to one-half) (11-13). Yet access to mental health services among individuals in substance abuse treatment is often problematic because of persistent administrative, funding, and structural barriers (14, A growing body of literature has examined the treatment outcomes of individuals with cooccurring disorders in substance abuse treatment programs. In general, research has shown that these individuals have lower rates of completing treatment, shorter stays in t...

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Mental health versus substance abuse treatment programs for dually diagnosed patients

Cited by 41 publications

References 27 publications

Psychiatric symptomatology among individuals in alcohol detoxification treatment

Psychiatric symptomatology among individuals in alcohol detoxification treatment

A reabilitação psicossocial na atenção aos transtornos associados ao consumo de álcool e outras drogas: uma estratégia possível?

Impact of Program Services on Treatment Outcomes of Patients With Comorbid Mental and Substance Use Disorders

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