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COMORBIDITY 2009 <422>
Database EMBASE
Accession Number 2009374355
Authors Mueser K.T. Glynn S.M. Cather C. Zarate R. Fox L. Feldman J. Wolfe R. Clark R.E.
Institution
(Mueser, Fox, Wolfe) Department of Psychiatry, Dartmouth Medical School, Hanover, NH, United States.
(Mueser) Department of Community and Family Medicine, Dartmouth Medical School, United States.
(Mueser, Fox, Wolfe) Dartmouth Psychiatric Research Center, Concord, NH, United States.
(Glynn) VA Greater Los Angeles Healthcare System at West Los Angeles, CA, United States.
(Glynn, Zarate) Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA,
United States.
(Cather) Schizophrenia Program, the Massachusetts General Hospital, Boston, MA, United States.
(Cather, Feldman) Harvard Medical School, Boston, MA, United States.
(Zarate) Pacific Clinics, Los Angeles, CA, United States.
(Feldman) Massachusetts Mental Health Center, Boston, MA, United States.
(Clark) Center for Health Policy and Research, University of Massachusetts Medical School, United States.
Country of Publication
United Kingdom
Title
Family intervention for co-occurring substance use and severe psychiatric disorders:
Participant characteristics and correlates of initial engagement and more extended
exposure in a randomized controlled trial.
Source
Addictive Behaviors. 34(10)(pp 867-877), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
Clients with severe mental illness and substance use disorder (i.e., dual disorders)
frequently have contact with family members, who may provide valuable emotional and
material support, but have limited skills and knowledge to promote recovery. Furthermore,
high levels of family conflict and stress are related to higher rates of relapse. The present
study was a two-site randomized controlled trial comparing a comprehensive, behaviorallybased family intervention for dual disorders program (FIDD) to a shorter-term family
psychoeducational program (FPE). The modal family was a single male son in his early 30s
diagnosed with both alcohol and drug problems and a schizophrenia-spectrum disorder
participating with his middle-aged mother, with whom he lived. Initial engagement rates
following consent to participate in the study and the family intervention programs were
moderately high for both programs (88% and 84%, respectively), but rates of longer term
retention and exposure to the core elements of each treatment model were lower (61% and
55%, respectively). Characteristics of the relatives were the strongest predictors of successful
initial engagement in the family programs with the most important predictor being relatives
who reported higher levels of benefit related to the relationship with the client. Subsequent
successful exposure to the family treatment models was more strongly associated with client
factors, including less severity of drug abuse and male client gender. The results suggest that
attention to issues of motivating relatives to participate in family intervention, and more
focused efforts to address the disruptive effects of drug abuse on the family could improve
rates of engagement and retention in family programs for dual disorders. copyright 2009
Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 867-877
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <423>
Database EMBASE
Accession Number 2009374347
Authors Kavanagh D.J. Connolly J.M.
Institution
(Kavanagh, Connolly) Institute of Health and Biomedical Innovation, Queensland University of Technology,
Australia.
(Kavanagh, Connolly) School of Psychology and Counselling, Queensland University of Technology, Australia.
Country of Publication
United Kingdom
Title
Interventions for co-occurring addictive and other mental disorders (AMDs).
Source
Addictive Behaviors. 34(10)(pp 838-845), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
While research on the management of co-occurring addictive and mental disorders (AMDs)
has grown substantially in recent years, we still have little guidance on specific strategies.
Consideration of epidemiological research and ethical principles can supplement existing
clinical trials in providing a way forward. High frequencies of co-occurring disorders, equity of
access for affected individuals and potential clashes between services in priorities and
procedures, suggest that a stepped model of care by a single service may often be required.
Typically, problems are multiple rather than dual, with potential for mutual influence,
suggesting a need for interventions that are sensitive to and encompass complex cooccurring problems. Motivational problems are endemic, initial gains are often partial and
unstable, and relapses potentially have serious consequences, suggesting a need for longterm, assertive follow-up. Principles such as these provide a solid framework for designing
both services and interventions. However, there is a continuing need for controlled trials that
unpack effective components of interventions, and increase their impact. copyright 2009
Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 838-845
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <424>
Database EMBASE
Accession Number 2009374349
Authors Mangrum L.F.
Institution
(Mangrum) University of Texas, Addiction Research Institute, 1717 West 6th Street, Suite 335, Austin, TX 78703,
United States.
Country of Publication
United Kingdom
Title
Client and service characteristics associated with addiction treatment completion of
clients with co-occurring disorders.
Source
Addictive Behaviors. 34(10)(pp 898-904), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
The study examines client and service characteristics of addiction treatment completers and
non-completers with co-occurring disorders (COD). On demographic variables, completers
were more likely to be male and homeless. In the psychiatric domain, a greater proportion of
completers received diagnoses of depression and generalized anxiety disorder, whereas noncompleters were more often diagnosed with bipolar disorder and posttraumatic stress
disorder. No group differences were found in client-reported psychiatric symptom severity;
however, non-completers were rated by clinicians as having more severe symptoms in the
areas of interpersonal sensitivity, depression, and hostility. In the area of substance use
patterns, no differences were found in primary substance of abuse but completers reported
more days of use during the month prior to treatment. Completers also had a greater history
of both prior detox and non-detox treatment. At discharge, completers achieved higher rates
of past month abstinence and AA attendance, but no differences were found in length of stay
in treatment. Examination of recovery support services utilization revealed that completers
more often received peer mentoring services. Greater proportions of the non-completer group
received educational support, clothing, medical care, and employment assistance. These
results suggest that future studies are needed in examining possible differential treatment
response by diagnostic category and the potential role of peer mentoring in enhancing
addiction treatment completion of COD clients. copyright 2009 Elsevier Ltd. All rights
reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 898-904
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <425>
Database EMBASE
Accession Number 2009374343
Authors Baker A. Turner A. Kay-Lambkin F.J. Lewin T.J.
Institution
(Baker, Turner) Centre for Brain and Mental Health Research, The University of Newcastle, University Drive,
Callaghan, NSW 2308, Australia.
(Kay-Lambkin) National Drug and Alcohol Research Centre, University of New South Wales, Randwick Campus,
Sydney, NSW 2052, Australia.
(Lewin) Centre for Brain and Mental Health Research, The University of Newcastle and Hunter New England Mental
Health, PO Box 833, Newcastle, NSW 2300, Australia.
Country of Publication
United Kingdom
Title
The long and the short of treatments for alcohol or cannabis misuse among people
with severe mental disorders.
Source
Addictive Behaviors. 34(10)(pp 852-858), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
Substance misuse among people with severe mental disorders is very common and has
been associated with a number of adverse outcomes. Most trials among people with severe
mental disorders have reported general substance misuse outcomes and have argued that
longer treatments are likely to be more effective. Such studies have not specifically compared
intervention effectiveness for alcohol vs. cannabis misuse. The present paper reports findings
from a synthesis of datasets from three randomized controlled trials (N = 248) comparing brief
(1-session advice or motivational interviewing, MI) and extended (10 sessions MI/cognitivebehaviour therapy; CBT) interventions for substance misuse among people with psychosis or
major depression and outcomes are reported separately for alcohol and cannabis use. Whilst
there were comparable rates of reduction in alcohol consumption for the BI and intensive
MI/CBT, BI tended to be associated with less reduction in cannabis use. A stepped care
approach for substance misuse in people with severe mental disorders may help to improve
cannabis outcomes, including monitoring of both mental health and substance misuse
domains, with interventions stepped up or down according to treatment response. Future
studies should evaluate the effectiveness of stepped care approaches. copyright 2009
Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 852-858
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <426>
Database EMBASE
Accession Number 2009374345
Authors Griffin M.L. Kolodziej M.E. Weiss R.D.
Institution
(Griffin, Kolodziej, Weiss) Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
(Griffin, Kolodziej, Weiss) Alcohol and Drug Abuse Treatment Program, McLean Hospital, 115 Mill Street, Belmont,
MA 02478, United States.
Country of Publication
United Kingdom
Title
Measuring principal substance of abuse in comorbid patients for clinical research.
Source
Addictive Behaviors. 34(10)(pp 826-829), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
Few individuals with substance use disorders limit their intake to one substance of abuse;
however, many studies focus on a single substance. Unfortunately, the optimal method to
determine the principal substance is unclear. In particular, this issue is problematic in patients
with co-occurring psychiatric illness, who commonly use multiple substances. Hence we
compared three methods for assessing the principal substance of abuse in 150 subjects with
bipolar disorder and substance dependence: 1) the Addiction Severity Index interview, 2) a
self-administered questionnaire, and 3) the most frequently used substance. While most
subjects were concordant on the interview and the other two methods, we found substantial
disagreement (9.3% between the interview and the questionnaire, and 12.7% between the
interview and the most frequently used substance) and partial agreement (14.0%). These
findings from a comorbid population demonstrate that different methods to assess principal
substance of abuse could lead to different conclusions about treatment outcomes. Hence
studies of comorbid patients may benefit from 1) using more than one method to assess
principal substance and 2) reporting use of all substances as well as a targeted substance.
copyright 2009 Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 826-829
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <430>
Database EMBASE
Accession Number 2009374357
Authors Hjorthoj C. Fohlmann A. Nordentoft M.
Institution
(Hjorthoj, Fohlmann, Nordentoft) Psychiatric Center Bispebjerg, Faculty of Health Sciences, Copenhagen
University: Bispebjerg Bakke 23, building 13A, DK-2400 Copenhagen NV, Denmark.
Country of Publication
United Kingdom
Title
Reprint of "Treatment of cannabis use disorders in people with schizophrenia
spectrum disorders - A systematic review".
Source
Addictive Behaviors. 34(10)(pp 846-851), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
Background: Cannabis use disorders (CUD) are prevalent among people with schizophrenia
spectrum disorders (SSD), with a range of detrimental effects, e.g. reduced compliance to
medication and psychosocial interventions, and increased level of psychotic-dimension
symptoms. The aim of this study was to review literature on treatments of CUD in SSDpatients. Methods: PubMed, PsycINFO, EMBASE, and The Cochrane Central Register of
Controlled Trials were searched. Results: 41 articles were selected, 11 treating cannabis as a
separate outcome. Contingency management was only effective while active.
Pharmacological interventions appeared effective, but lacked randomized controlled trials
(RCTs). Psychosocial interventions, e.g. motivational interviewing and cognitive behavior
therapy (CBT), were ineffective in most studies with cannabis as a separate outcome, but
effective in studies that grouped cannabis together with other substance use disorders.
Conclusions: Insufficient evidence exists on treating this form of dual-diagnosis patients.
Studies grouping several types of substances as a single outcome may overlook differential
effects. Future RCTs should investigate combinations of psychosocial, pharmacological, and
contingency management. copyright 2009 Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 846-851
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <431>
Database EMBASE
Accession Number 2009412459
Authors Degenhardt L. Whiteford H. Hall W. Vos T.
Institution
(Degenhardt) National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW,
Australia.
(Whiteford) Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Australia.
(Hall, Vos) School of Population Health, University of Queensland, Brisbane, Australia.
Country of Publication
United Kingdom
Title
Estimating the burden of disease attributable to illicit drug use and mental disorders:
What is 'Global Burden of Disease 2005' and why does it matter?
Source
Addiction. 104(9)(pp 1466-1471), 2009. Date of Publication: September 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Background The estimated impact of illicit drug use and mental disorders upon population
health needs to be understood because there is evidence that they produce substantial loss
of life and disability, and information is needed on the comparative population health impact of
different diseases and risk factors to help focus policy, service and research planning and
execution. Aims To provide an overview of a global project, running since the end of 2007 Global Burden of Disease (GBD) 2005. Methods The new GBD aims to update
comprehensively the findings of the first GBD exercise. It aims to provide regional and global
estimates of the burden of disease attributable to hundreds of diseases, injuries and their risk
factors. Groups have been assembled to provide expert advice on the parameters needed to
inform these estimates; here, we provide a brief summary of the broad range of work being
undertaken by the group examining illicit drug use and mental disorders. Discussion The
estimates of the contribution of mental disorders and illicit drugs to GBD will inform and
potentially shape the focus of researchers, clinicians and governments in the years to come.
We hope that interested readers might be encouraged to submit new data or feedback on the
work completed thus far, as well as the work that is still under way and yet to be completed.
copyright 2009 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Review
Journal Name Addiction
Volume 104
Issue Part 9
Page 1466-1471
Year of Publication 2009
Date of Publication September 2009
COMORBIDITY 2009 <463>
Database EMBASE
Accession Number 2009368856
Authors Shora S. Stone E. Fletcher K.
Institution
(Shora) Barnet, Enfield and Haringey Mental Health NHSTrust, Chase Farm Hospital, Enfield,
(Stone, Fletcher) New House Drug and Alcohol Unit, Shelton Hospital, Shrewsbury SY3 8DN,
Country of Publication
United Kingdom
Title
Substance use disorders and psychological trauma.
Source
Psychiatric Bulletin. 33(7)(pp 257-260), 2009. Date of Publication: July 2009.
Publisher
Royal College of Psychiatrists
Abstract
AIMS AND METHOD: The Impact of Events Scale was administered to 104 in-patients
detoxing from alcohol or opiates to determine the prevalence of psychological trauma, the
severity of its symptoms and the types of trauma responsible for symptoms. RESULTS: Out
of the 104 in-patients undergoing detoxification, 75 had symptoms of psychological trauma; in
60 patients the symptoms were in the treatable range. Patients with alcohol-dependence were
more severely affected. 'Life events' traumatised a higher proportion of individuals than
'traumatic events'. CLINICAL IMPLICATIONS: Psychological trauma requiring treatment is
commonly found in substance misusers. This is rarely addressed despite the cormorbid
disorder running a complicated clinical course. There are conflicting opinions about best
practice, but consideration should be given to providing patients with accessible treatments
for psychological trauma.
ISSN 0955-6036
Publication Type Journal: Article
Journal Name Psychiatric Bulletin
Volume 33
Issue Part 7
Page 257-260
Year of Publication 2009
Date of Publication July 2009
COMORBIDITY 2009 <479>
Database EMBASE
Accession Number 2009401347
Authors Barrowclough C. Haddock G. Beardmore R. Conrod P. Craig T. Davies L. Dunn G. Lewis S. Moring J.
Tarrier N. Wykes T.
Institution
(Barrowclough, Haddock, Beardmore, Tarrier) School of Psychological Sciences, University of Manchester,
Zochonis Building, Oxford Road, M13 9PL, United Kingdom.
(Conrod, Craig, Wykes) Institute of Psychiatry, Kings College London, De Crespigny Park, London, SE5 8AF,
United Kingdom.
(Davies, Dunn, Lewis) Community Based Medicine, University of Manchester, University Place, Oxford Road, M13
9PL, United Kingdom.
(Moring) Substance Misuse Directorate, Greater Manchester West Mental Health NHS Foundation Trust, Bury New
Road, Prestwich, M25 3BL, United Kingdom.
Country of Publication
United Kingdom
Title
Evaluating integrated MI and CBT for people with psychosis and substance misuse:
Recruitment, retention and sample characteristics of the MIDAS trial.
Source
Addictive Behaviors. 34(10)(pp 859-866), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
Major problems with existing RCTs evaluating psychosocial interventions for psychosis and
substance misuse have been identified, in particular small sample sizes, high attrition rates,
and short follow up periods. With a sample size of 327 and a follow up of 2 years, the MIDAS
trial in the UK is to date the largest RCT for people with psychosis and substance use and is
evaluating an integrated MI and CBT ("MiCBT") client therapy. Whilst the outcomes of the
study are not yet available, data on recruitment and retention indicate that attrition rates in
MIDAS are low and the majority of those allocated to treatment received a substantial number
of therapy sessions. Sample characteristics are in line with those reported in epidemiological
studies and are indicative of the challenges facing mental health services attempting to
manage the client group: substance use is often longstanding, with frequent use at moderate
or severe level and low motivation for change, and seen in the context of low levels of
functioning and significant psychopathology. We conclude that this is a methodologically
robust study that will have results generalisable to mental health services. copyright 2009
Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 859-866
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <480>
Database EMBASE
Accession Number 2009401346
Authors Hides L. Cotton S.M. Berger G. Gleeson J. O'Donnell C. Proffitt T. McGorry P.D. Lubman D.I.
Institution
(Hides, Cotton, Berger, Gleeson, O'Donnell, Proffitt, McGorry, Lubman) Orygen Youth Health Research Centre,
Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville Melbourne, Vic. 3052, Australia.
(Berger) The Schloessli Clinic, Department of Research and Education, Oetwil am See, Switzerland.
(Gleeson) Department of Psychology, The University of Melbourne and NorthWestern Mental Health, a program of
Melbourne Health, Australia.
Country of Publication
United Kingdom
Title
The reliability and validity of the Alcohol, Smoking and Substance Involvement
Screening Test (ASSIST) in first-episode psychosis.
Source
Addictive Behaviors. 34(10)(pp 821-825), 2009. Date of Publication: October 2009.
Publisher
Elsevier Ltd
Abstract
Aims: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a brief,
easily administered, valid and reliable screening instrument for all psychoactive substances in
drug treatment and primary care settings. This study aims to determine the reliability and
validity of the ASSIST for detecting substance use disorders in first-episode psychosis.
Participants: Participants were 214 first-episode psychosis patients attending the Early
Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Australia.
Measurements: Participants were administered the ASSIST, Alcohol Use Disorders
Identification Test (AUDIT), the Severity of Dependence Scale (SDS) and the Brief Psychiatric
Rating Scale (BPRS). Presence of DSM-IV substance abuse and dependence disorders in
the previous 12 months was assessed using the Structured Clinical Interview for DSM-IV
(SCID-IV). Findings: The ASSIST total substance involvement (TSI) score and specific
substance involvement (SSI) scores for cannabis, alcohol and amphetamine use
demonstrated high levels of internal consistency and acceptable levels of concurrent and
discriminative validity. Individuals with cutoff scores of [greater-than or equal to] 2, 4 and 1 on
the ASSIST cannabis, alcohol and amphetamine SSI scores were 5 to 6 times more likely to
meet the diagnostic criteria for these substance use disorders. Conclusions: The ASSIST is a
psychometrically sound measure of cannabis, alcohol and amphetamine use disorders in firstepisode psychosis. copyright 2009 Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 34
Issue Part 10
Page 821-825
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <510>
Database EMBASE
Accession Number 2009441641
Authors Atakan Z.
Institution
(Atakan) Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom.
Country of Publication
United Kingdom
Title
Managing cannabis use in people with severe mental illness: What can be done?.
Source
Advances in Psychiatric Treatment. 15(1)(pp 65-71), 2009. Date of Publication: 2009.
Publisher
Royal College of Psychiatrists
Abstract
Nearly half of people with severe mental illness use cannabis sometime in their lives and
during their illness. Its use can have multiple and severe consequences for the course of the
illness. Despite the significance of the problem, managing cannabis use in this group is a
recently developing topic and is still in its infancy. This article reviews the current state of
knowledge on the management of people with severe mental illness who continue to use
cannabis, specifically focusing on different models of service provision, and psychological and
pharmacological interventions.
ISSN 1355-5146
Publication Type Journal: Review
Journal Name Advances in Psychiatric Treatment
Volume 15
Issue Part 1
Page 65-71
Year of Publication 2009
Date of Publication 2009
COMORBIDITY 2009 <513>
Database EMBASE
Accession Number 2009463068
Authors Mason O. Morgan C.J.A. Dhiman S.K. Parti N. Patel A. Curran H.V.
Institution
(Mason, Morgan, Dhiman, Patel, Parti, Patel, Curran) Clinical Psychopharmacology Unit, Clinical Health
Psychology, University College London, Gower Street, London WC1E 6BT, United Kingdom.
Country of Publication
United Kingdom
Title
Acute cannabis use causes increased psychotomimetic experiences in individuals
prone to psychosis.
Source
Psychological Medicine. 39(6)(pp 951-956), 2009. Date of Publication: June 2009.
Publisher
Cambridge University Press
Abstract
Background: Epidemiological evidence suggests a link between cannabis use and
psychosis. A variety of factors have been proposed to mediate an individual's vulnerability to
the harmful effects of the drug, one of which is their psychosis proneness. We hypothesized
that highly psychosis-prone individuals would report more marked psychotic experiences
under the acute influence of cannabis. Method: A group of cannabis users (n=140) completed
the Psychotomimetic States Inventory (PSI) once while acutely intoxicated and again when
free of cannabis. A control group (n=144) completed the PSI on two parallel test days. All
participants also completed a drug history and the Schizotypal Personality Questionnaire
(SPQ). Highly psychosis-prone individuals from both groups were then compared with
individuals scoring low on psychosis proneness by taking those in each group scoring above
and below the upper and lower quartiles using norms for the SPQ. Results: Smoking
cannabis in a naturalistic setting reliably induced marked increases in psychotomimetic
symptoms. Consistent with predictions, highly psychosis-prone individuals experienced
enhanced psychotomimetic states following acute cannabis use. Conclusions: These findings
suggest that an individual's response to acute cannabis and their psychosis-proneness
scores are related and both may be markers of vulnerability to the harmful effects of this drug.
Copyright copyright Cambridge University Press 2008.
ISSN 0033-2917
Publication Type Journal: Article
Journal Name Psychological Medicine
Volume 39
Issue Part 6
Page 951-956
Year of Publication 2009
Date of Publication June 2009
COMORBIDITY 2009 <547>
Database EMBASE
Accession Number 2009478764
Authors Niciu M.J. Chan G. Gelernter J. Arias A.J. Douglas K. Weiss R. Anton R.F. Farrer L. Cubells J.F. Kranzler
H.R.
Institution
(Niciu, Chan, Arias, Douglas, Kranzler) Department of Psychiatry, University of Connecticut Health Center, 263
Farmington Avenue, Farmington, CT 06030-2103, United States.
(Gelernter) Departments of Psychiatry, Genetics, and Neurobiology, School of Medicine, Yale University, New
Haven, CT, United States.
(Gelernter) VA CT Healthcare Center, West Haven, CT, United States.
(Weiss) Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
(Weiss) McLean Hospital, Belmont, MA, United States.
(Anton) Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC,
United States.
(Farrer) Departments of Medicine , Neurology, Genetics and Genomics, Epidemiology, and Biostatistics, Boston
University, Schools of Medicine and Public Health, Boston, MA, United States.
(Cubells) Departments of Human Genetics and Psychiatry and Behavioral Sciences, Emory University School of
Medicine, Atlanta, GA, United States.
(Kranzler) Department of Genetics and Developmental Biology, University of Connecticut, School of Medicine,
Farmington, CT, United States.
Country of Publication
United Kingdom
Title
Subtypes of major depression in substance dependence.
Source
Addiction. 104(10)(pp 1700-1709), 2009. Date of Publication: October 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Aims This study evaluated features that differentiate subtypes of major depressive episode
(MDE) in the context of substance dependence (SD). Design Secondary data analysis using
pooled data from family-based and case-control genetic studies of SD. Setting Community
recruitment through academic medical centers. Participants A total of 1929 unrelated subjects
with alcohol and/or drug dependence. Measurements Demographics, diagnostic criteria for
psychiatric and substance use disorders and related clinical features were obtained using the
Semi-Structured Assessment for Drug Dependence and Alcoholism. We compared four
groups: no life-time MDE (no MDE), independent MDE only (I-MDE), substance-induced MDE
only (SI-MDE) and both types of MDE. Findings Psychiatric measures were better predictors
of MDE subtype than substance-related or socio-demographic ones. Subjects with both types
of MDE reported more life-time depressive symptoms and comorbid anxiety disorders and
were more likely to have attempted suicide than subjects with I-MDE or SI-MDE. Subjects
with both types of MDE, like those with I-MDE, were also more likely than subjects with SIMDE to be alcohol-dependent only than either drug-dependent only or both alcohol- and drugdependent. Conclusions SD individuals with both types of MDE have greater psychiatric
severity than those with I-MDE only or SI-MDE only. These and other features that distinguish
among the MDE subtypes have important diagnostic and potential therapeutic implications.
copyright 2009 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Article
Journal Name Addiction
Volume 104
Issue Part 10
Page 1700-1709
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <547>
Database EMBASE
Accession Number 2009478764
Authors Niciu M.J. Chan G. Gelernter J. Arias A.J. Douglas K. Weiss R. Anton R.F. Farrer L. Cubells J.F. Kranzler
H.R.
Institution
(Niciu, Chan, Arias, Douglas, Kranzler) Department of Psychiatry, University of Connecticut Health Center, 263
Farmington Avenue, Farmington, CT 06030-2103, United States.
(Gelernter) Departments of Psychiatry, Genetics, and Neurobiology, School of Medicine, Yale University, New
Haven, CT, United States.
(Gelernter) VA CT Healthcare Center, West Haven, CT, United States.
(Weiss) Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
(Weiss) McLean Hospital, Belmont, MA, United States.
(Anton) Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC,
United States.
(Farrer) Departments of Medicine , Neurology, Genetics and Genomics, Epidemiology, and Biostatistics, Boston
University, Schools of Medicine and Public Health, Boston, MA, United States.
(Cubells) Departments of Human Genetics and Psychiatry and Behavioral Sciences, Emory University School of
Medicine, Atlanta, GA, United States.
(Kranzler) Department of Genetics and Developmental Biology, University of Connecticut, School of Medicine,
Farmington, CT, United States.
Country of Publication
United Kingdom
Title
Subtypes of major depression in substance dependence.
Source
Addiction. 104(10)(pp 1700-1709), 2009. Date of Publication: October 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Aims This study evaluated features that differentiate subtypes of major depressive episode
(MDE) in the context of substance dependence (SD). Design Secondary data analysis using
pooled data from family-based and case-control genetic studies of SD. Setting Community
recruitment through academic medical centers. Participants A total of 1929 unrelated subjects
with alcohol and/or drug dependence. Measurements Demographics, diagnostic criteria for
psychiatric and substance use disorders and related clinical features were obtained using the
Semi-Structured Assessment for Drug Dependence and Alcoholism. We compared four
groups: no life-time MDE (no MDE), independent MDE only (I-MDE), substance-induced MDE
only (SI-MDE) and both types of MDE. Findings Psychiatric measures were better predictors
of MDE subtype than substance-related or socio-demographic ones. Subjects with both types
of MDE reported more life-time depressive symptoms and comorbid anxiety disorders and
were more likely to have attempted suicide than subjects with I-MDE or SI-MDE. Subjects
with both types of MDE, like those with I-MDE, were also more likely than subjects with SIMDE to be alcohol-dependent only than either drug-dependent only or both alcohol- and drugdependent. Conclusions SD individuals with both types of MDE have greater psychiatric
severity than those with I-MDE only or SI-MDE only. These and other features that distinguish
among the MDE subtypes have important diagnostic and potential therapeutic implications.
copyright 2009 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Article
Journal Name Addiction
Volume 104
Issue Part 10
Page 1700-1709
Year of Publication 2009
Date of Publication October 2009
COMORBIDITY 2009 <559>
Database EMBASE
Accession Number 2009473198
Authors Carr J.A.R. Norman R.M.G. Manchanda R.
Institution
(Carr, Norman, Manchanda) Prevention and Early Intervention Program for Psychoses (PEPP), Department of
Psychiatry, University of Western Ontario, London, ON, Canada.
(Carr) PEPP, London Health Sciences Center, South Street Hospital, 372 South Street, London, ON N6A 4G5,
Canada.
Country of Publication
United Kingdom
Title
Substance misuse over the first 18 months of specialized intervention for first
episode psychosis.
Source
Early Intervention in Psychiatry. 3(3)(pp 221-225), 2009. Date of Publication: 2009.
Publisher
Blackwell Publishing
Abstract
Aim: Examine substance misuse over the first 18 months of first-episode psychosis
treatment. Method: Clinicians rated alcohol and drug (mostly cannabis) misuse for 243
individuals followed prospectively. Assessments were completed at baseline and after 3, 6
and 18 months. Interventions relating to substance misuse included ongoing assessment of
use, education and counselling to avoid. Results: Alcohol and drug misuse declined
significantly between baseline and 3 months, especially among patients with a substance
abuse or dependence diagnosis at baseline. Overall, these reductions were maintained over
the 18-month follow-up period. The exception was worsening alcohol misuse over time
among patients with alcohol abuse or dependence on entry. Conclusions: With good usual
care, education and support, alcohol and drug misuse declined significantly during the first
months of psychosis treatment. The improvements in drug misuse were generally maintained
over the 18-month follow-up, and worsening alcohol misuse over time may be the greater
issue. copyright 2009 The Authors Journal compilation copyright 2009 Blackwell Publishing
Asia Pty Ltd.
ISSN 1751-7885
Publication Type Journal: Article
Journal Name Early Intervention in Psychiatry
Volume 3
Issue Part 3
Page 221-225
Yearof Publication 2009
Date of Publication 2009
COMORBIDITY 2009 <560>
Database EMBASE
Accession Number 2009473195
Authors Kamali M. Mctigue O. Whitty P. Gervin M. Clarke M. Browne S. Larkin C. O'callaghan E.
Institution
(Kamali, Mctigue, Whitty, Gervin, Clarke, Browne, Larkin, O'callaghan) Department of Psychiatry, University College
Dublin, St John of God Adult Psychiatric Services, Dublin, Ireland.
(Kamali) Newcastle Hospital, Greystones, Co Wicklow, Ireland.
Country of Publication
United Kingdom
Title
Lifetime history of substance misuse in first-episode psychosis: Prevalence and its
influence on psychopathology and onset of psychotic symptoms.
Source
Early Intervention in Psychiatry. 3(3)(pp 198-203), 2009. Date of Publication: 2009.
Publisher
Blackwell Publishing
Abstract
Introduction: Substance misuse (SM) (drug/alcohol dependence or abuse) in psychotic
illness is an increasingly recognized problem. We aimed to estimate the prevalence and
examine the influence of SM on age at onset of psychosis and psychopathology among
patients with first-episode psychosis. Method: One hundred seventy-one consecutive patients
with first-episode psychosis were assessed. SM, age of onset of psychosis and
psychopathology were determined using valid instruments. Results: Seventy-seven (46%)
patients had a lifetime history of SM and were predominately males, had more positive
symptoms, and in the majority of cases (84%), started misusing substances before the onset
of psychosis (SM-BP). There was no difference in age of onset between patients with SM-BP
and the rest of the sample. Conclusion: Lifetime history of SM is common and may influence
psychopathology, but does not appear to influence or bring forward the age at onset of
psychotic symptoms. copyright 2009 The Authors Journal compilation copyright 2009
Blackwell Publishing Asia Pty Ltd.
ISSN 1751-7885
Publication Type Journal: Article
Journal Name Early Intervention in Psychiatry
Volume 3
Issue Part 3
Page 198-203
Year of Publication 2009
Date of Publication 2009
COMORBIDITY 2009 <584>
Database EMBASE
Accession Number 2009488329
Authors Larsen J.K. Porsdal V. Aarre T.F. Koponen H.J. Aarnio J. Kleivenes O.K.
Institution
(Larsen) Gentofte Psychiatric Centre, Hellerup, Denmark.
(Porsdal) Eli Lilly Denmark, Lyngby, Denmark.
(Aarre) Nordfjord Psychiatric Centre, Nordfjordeid, Norway.
(Koponen) Department of Psychiatry, Kuopio University, Kuopio University of Hospital, Kuopio, Finland.
(Aarnio) Hameenlinna Prison Hospital, Hameenlinna, Finland.
(Kleivenes) Eli Lilly Norge A.S, Etterstad, Oslo, Norway.
Country of Publication
United Kingdom
Title
Mania in the Nordic countries: Patients and treatment in the acute phase of the
EMBLEM study.
Source
Nordic Journal of Psychiatry. 63(4)(pp 285-291), 2009. Date of Publication: 2009.
Publisher
Informa Healthcare
Abstract
In bipolar disorder, mood stabilizers and second-generation antipsychotics have a central
role in pharmacotherapy. There are, however, substantial differences in how the treatment is
realized in different countries. The aim of this paper was to compare the treatment of acute
mania in the Nordic countries with other European countries during the first 12 weeks of the
EMBLEM (European Mania in Bipolar Longitudinal Evaluation of Medication) study. Adult
patients with bipolar disorder were enrolled within standard course of care as in/ outpatients if
they initiated/changed oral medication with antipsychotics, anticonvulsants or lithium for
treatment of acute mania. Five hundred and thirty European psychiatrists including 23 Nordic
psychiatrists enrolled 3459 patients including 79 Nordic patients eligible for analysis using the
same study methods assessing demographics, psychiatric history, clinical status, functional
status and pharmacological treatment. Psychiatric status at inclusion measured by the Young
Mania Rating Scale (YMRS) and the Clinical Global Impression-Bipolar Disorder (CGI-BP)
were similar in the Nordic and European patient groups, which is surprising as 73% of the
Nordic patients compared with 38% of the European patients were inpatients. In the Nordic
group of patients, more patients were living independently. Before inclusion in the study more
patients in the Nordic group had combination therapy, but after inclusion in the study the
prescription pattern of psychopharmacy was similar in the Nordic and the European patient
groups. This study indicated differences in admission patterns, patient social functioning and
medical treatment in the Nordic patients compared with the European patients.
ISSN 0803-9488
Publication Type Journal: Article
Journal Name Nordic Journal of Psychiatry
Volume 63
Issue Part 4
Page 285-291
Year of Publication 2009
Date of Publication 2009
COMORBIDITY 2009 <607>
Database EMBASE
Accession Number 2009534816
Authors Hickman M. Vickerman P. MacLeod J. Lewis G. Zammit S. Kirkbride J. Jones P.
Institution
(Hickman, Vickerman, MacLeod) Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8
2PR, United Kingdom.
(Vickerman) Modelling Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom.
(Lewis, Zammit) Academic Psychiatry, University of Bristol, Bristol, United Kingdom.
(Zammit) Department of Psychological Medicine, Cardiff University, Cardiff, United Kingdom.
(Kirkbride, Jones) Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
Country of Publication
United Kingdom
Title
If cannabis caused schizophrenia - How many cannabis users may need to be
prevented in order to prevent one case of schizophrenia? England and Wales
calculations.
Source
Addiction. 104(11)(pp 1856-1861), 2009. Date of Publication: November 2009.
Publisher
Blackwell Publishing Ltd
Abstract
Background We consider how many cannabis users may need to be prevented in order to
prevent one case of schizophrenia or psychosis [defined as number needed to prevent
(NNP)]. Method Calculation for England and Wales using best available estimates of:
incidence of schizophrenia; rates of heavy and light cannabis use; and risk that cannabis
causes schizophrenia. Results In men the annual mean NNP for heavy cannabis and
schizophrenia ranged from 2800 [90% confidence interval (CI) 2018-4530] in those aged 2024 years to 4700 (90% CI 3114-8416) in those aged 35-39. In women, mean NNP for heavy
cannabis use and schizophrenia ranged from 5470 (90% CI 3640-9839) in those aged 25-29
to 10 870 (90% CI 6786-22 732) in 35-39-year-olds. Equivalent mean NNP for heavy
cannabis use and psychosis were lower, from 1360 (90% CI 1007-2124) in men aged 20-24
and 2480 (90% CI 1408-3518) in women aged 16-19. The mean and median number of light
cannabis users that would need to be prevented in order to prevent one case of
schizophrenia or psychosis per year are four to five times greater than among heavy users.
Conclusions The number of young people who need to be exposed to an intervention to
generate NNP and prevent one case of schizophrenia will be even larger. The public health
importance of preventing cannabis to reduce schizophrenia or psychosis remains uncertain.
More attention should be given to testing the hypothesis that cannabis is related causally to
psychotic outcomes, and to considering what strategies will be the most effective in reducing
heavy cannabis use among young people. copyright 2009 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Article
Journal Name Addiction
Volume 104
Issue Part 11
Page 1856-1861
Year of Publication 2009
Date of Publication November 2009
COMORBIDITY 2009 <626>
Database EMBASE
Accession Number 2009469757
Authors Vigano D. Guidali C. Petrosino S. Realini N. Rubino T. Di Marzo V. Parolaro D.
Institution
(Vigano, Guidali, Realini, Rubino, Parolaro) DBSF and Neuroscience Centre, University of Insubria, Via A. da
Giussano 10, 21052 Busto Arsizio (VA), Italy.
(Petrosino, Di Marzo) Endocannabinoid Research Group, Institute of Biomolecular Chemistry, CNR, Pozzuoli (NA),
Italy.
Country of Publication
United Kingdom
Title
Involvement of the endocannabinoid system in phencyclidine-induced cognitive
deficits modelling schizophrenia.
Source
International Journal of Neuropsychopharmacology. 12(5)(pp 599-614), 2009. Date of
Publication: June 2009.
Publisher
Cambridge University Press
Abstract
Recent advances in the neurobiology of cannabinoids have renewed interest in the
association between cannabis and schizophrenia. Our studies showed that chronicintermittent phencyclidine (PCP) treatment of rats, an animal model of schizophrenia-like
cognitive deficit, impaired recognition memory in the novel object recognition (NOR) test and
induced alterations in CB1 receptor functionality and in endocannabinoid levels mainly in the
prefrontal cortex. In this region, we observed a significant reduction in GTPS binding (41%)
accompanied by an increase in the levels of the endocannabinoid 2-AG (+38%) in PCPtreated rats, suggesting that a maladaptation of the endocannabinoid system might contribute
to the glutamatergic-related cognitive symptoms encountered in schizophrenia disorders.
Moreover, we evaluated the ability of the main psychoactive ingredient of marijuana, 9tetrahydrocannabinol (THC), to modulate the cognitive dysfunctions and neuroadaptations in
the endocannabinoid system induced by PCP. Chronic THC co-treatment worsened PCPinduced cognitive impairment, without inducing any effect per se, and in parallel, it provoked a
severe reduction in the levels of the other endocannabinoid, AEA, vs. either vehicle (73%) or
PCP (64%), whereas it reversed the PCP-induced increase in 2-AG levels. These results
point to the involvement of the endocannabinoid system in this pharmacological model of
cognitive dysfunction, with a potentially different role of AEA and 2-AG in schizophrenia-like
behaviours and suggest that prolonged cannabis use might aggravate cognitive performances
induced by chronic PCP by throwing off-balance the endocannabinoid system. copyright
Copyright 2008 CINP.
ISSN 1461-1457
Publication Type Journal: Article
Journal Name International Journal of Neuropsychopharmacology
Volume 12
Issue Part 5
Page 599-614
Year of Publication 2009
Date of Publication June 2009
COMORBIDITY 2009 <669>
Database EMBASE
Accession Number 2009598336
Authors Grigoletti L. Perini G. Rossi A. Biggeri A. Barbui C. Tansella M. Amaddeo F.
Institution
(Grigoletti, Perini, Rossi, Barbui, Tansella, Amaddeo) Department of Medicine and Public Health, Section of
Psychiatry and Clinical Psychology, University of Verona, Italy.
(Biggeri) Department of Statistics, University of Florence, Italy.
Country of Publication
United Kingdom
Title
Mortality and cause of death among psychiatric patients: A 20-year case-register
study in an area with a community-based system of care.
Source
Psychological Medicine. 39(11)(pp 1875-1884), 2009. Date of Publication: November 2009.
Publisher
Cambridge University Press
Abstract
Background Most mortality studies of psychiatric patients published to date have been
conducted in hospital-based systems of care. This paper describes a study of the causes of
death and associated risk factors among psychiatric patients who were followed up over a 20year period in an area where psychiatric care is entirely provided by community-based
psychiatric services.Method All subjects in contact with the South Verona Community-based
Mental Health Service (CMHS) over a 20-year period with an ICD-10 psychiatric diagnosis
were included. Of these 6956 patients, 938 died during the study period. Standardized
mortality ratios (SMRs) and Poisson multiple regressions were used to assess the excess of
mortality in the sample compared with the general population.Results The overall SMR of the
psychiatric patients was 1.88. Mortality was significantly high among out-patients [SMR 1.71,
95% confidence interval (CI) 1.61.8], and higher still following the first admission (SMR 2.61,
95% CI 2.42.9). The SMR for infectious diseases was higher among younger patients and
extremely high in patients with diagnoses of drug addiction (216.40, 95% CI 142.5328.6) and
personality disorders (20.87, 95% CI 5.283.4).Conclusions This study found that psychiatric
patients in contact with a CMHS have an almost twofold higher mortality rate than the general
population. These findings demonstrate that, since the closure of long-stay psychiatric
hospitals, the physical health care of people with mental health problems is often neglected
and clearly requires greater attention by health-care policymakers, services and
professionals. copyright 2009 Cambridge University Press.
ISSN 0033-2917
Publication Type Journal: Article
Journal Name Psychological Medicine
Volume 39
Issue Part 11
Page 1875-1884
Year of Publication 2009
Date of Publication November 2009
COMORBIDITY 2009 <705>
Database EMBASE
Accession Number 2009585417
Authors Cairney J. Veldhuizen S. Faulkner G. Schaffer A. Rodriguez M.C.
Institution
(Cairney, Rodriguez) Department of Family Medicine, McMaster University, 175 Longwood Road South, Hamilton,
Ont. L8P 0A1, Canada.
(Cairney) Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada.
(Cairney, Veldhuizen) Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, 33
Russell St., 3rd Floor Tower, Toronto, Ont. M5S 2S1, Canada.
(Faulkner) Faculty of Physical Education and Health, University of Toronto, 55 Harbord St, Toronto, Ont. M5S 2W6,
Canada.
(Schaffer) Mood Disorders Program, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview
Ave, Toronto, Ont. M4N 3M5, Canada.
(Schaffer) Department of Psychiatry, University of Toronto, 2075 Bayview Ave, Toronto, Ont. M4N 3M5, Canada.
Country of Publication
United Kingdom
Title
Bipolar disorder and leisure-time physical activity: Results from a national survey of
Canadians.
Source
Mental Health and Physical Activity. 2(2)(pp 65-70), 2009. Date of Publication: December
2009.
Publisher
Elsevier Ltd
Abstract
Purpose: The aim of this study was to compare patterns of PA and its potential correlates in
individuals with BD to the general population using a representative sample of Canadians.
Methods: We used data from the 2002 Canadian Community Health Survey 1.2, a national,
cross-sectional survey focusing on mental health and addiction (n = 36,984). We compared
PA levels among individuals with BD (n = 831) to those diagnosed with major depression (n =
4713) and those with no identified mood disorder (n = 31,834). Using multivariable logistic
regression, we then compared independent effects of sociodemographic and clinical factors in
active and inactive BD individuals stratified by relative weight status. Results: There were no
differences in the proportion of individuals characterized as active, moderately active or
inactive among individuals with BD, major depressive disorder or the general population. No
sociodemographic or clinical variables were related to PA in individuals with BD, and the
relationships between these variables and PA level were not different than those observed in
the general population. BD status was independently associated with being overweight (OR =
1.26, p = 0.03). An interaction between BD status and PA was also observed (OR = 1.12, p =
0.005), suggesting a reduced role for PA in reducing the risk of being overweight in person
with BD. Conclusions: The results suggest that levels of self-reported PA are not lower among
people with BD living in the community than in the general population. Future research should
assess levels of PA using objective measures and determine whether PA improves
psychosocial outcomes in this population. copyright 2009 Elsevier Ltd. All rights reserved.
ISSN 1755-2966
Publication Type Journal: Article
Journal Name Mental Health and Physical Activity
Volume 2
Issue Part 2
Page 65-70
Year of Publication 2009
Date of Publication December 2009
COMORBIDITY 2009 <724>
Database EMBASE
Accession Number 2009616875
Authors Tucker P.
Institution
(Tucker) Mental Health (East), Sydney West Area Health Service, NSW, Australia.
Country of Publication
United Kingdom
Title
Substance misuse and early psychosis.
Source
Australasian Psychiatry. 17(4)(pp 291-294), 2009. Date of Publication: 2009.
Publisher
Informa Healthcare
Abstract
Objective: This paper sought to review current knowledge about the relationship between
substance misuse and early psychosis. Methods: A literature search was conducted using
Medline and restricting the search to articles after 1996. Additional articles were sourced from
reference lists of relevant articles. Results: There is a high prevalence of substance misuse
among persons with early psychosis, with cannabis and alcohol featuring prominently.
Substance misuse is associated with earlier onset and possibly more positive symptoms,
although apparently not with greater cognitive impairment. Cannabis appears to confer an
increased likelihood of developing schizophrenia in biologically vulnerable individuals.
Amphetamines also cause psychosis which may become chronic, although specific
vulnerability to this effect is less well established. Many cases of so-called 'drug-induced
psychosis' become diagnosed as schizophrenia in later years. Specific intervention programs
report positive outcomes with regard to substance misuse and the course of psychosis.
Conclusions: Substance misuse should always be assessed in this patient group, bearing in
mind the potential interactive causes of psychopathology. Intervention is of value in improving
outcomes. copyright 2009 The Royal Australian and New Zealand College of Psychiatrists.
ISSN 1039-8562
Publication Type Journal: Short Survey
Journal Name Australasian Psychiatry
Volume 17
Issue Part 4
Page 291-294
Year of Publication 2009
Date of Publication 2009
COMORBIDITY 2009 <726>
Database EMBASE
Accession Number 2009579609
Authors Arvidsson H.
Institution
(Arvidsson) Gteborg University, Department of Psychology, Gteborg, Sweden.
(Arvidsson) Department of Psychiatry, Ryhov County Hospital, 551 85 Jnkping, Sweden.
Country of Publication
United Kingdom
Title
Severely and persistently mentally illA changing group. Ten years after the 1995
Swedish mental health care reform.
Source
Nordic Journal of Psychiatry. 63(5)(pp 355-360), 2009. Date of Publication: 2009.
Publisher
Informa Healthcare
Abstract
Aim: A mental health care reform was implemented in Sweden in 1995. The target group of
the reform was persons considered severely and persistently mentally ill (SMI). The aim of
this article was to study changes in the target group 10 years after the reform, i.e. changes in
the group of persons defined as SMI. Methods: Inventories of persons considered SMI were
made in a municipality of Sweden in 1995/96, 2000/2001 and 2006 based on the same
definition. The invented persons were interviewed. The same interview procedures,
questionnaires and need assessments were used on all three occasions. The results were
based on comparing the new groups considered SMI in 2000/2001 and 2006. Results: In
2006, the group of persons considered SMI was younger. Fewer persons with a diagnosis of
schizophrenia and more persons with a diagnosis of mood disorders or addictive problems
were included. Problems concerning relations and physical health were more evident. A
greater part had all their income from social security in 2006, and fewer persons were
occupied in some kind of salaried employment, full-time or half-time, regular or sheltered.
Conclusion: The target group of the reform had changed and other groups of persons were
considered SMI in 2006. These new groups require other strategies of care. copyright 2009
Informa UK Ltd.
ISSN 0803-9488
Publication Type Journal: Article
Journal Name Nordic Journal of Psychiatry
Volume 63
Issue Part 5
Page 355-360
Year of Publication 2009
Date of Publication 2009
COMORBIDITY 2009 <728>
Database EMBASE
Accession Number 2009551150
Authors Ruud T.
Institution
(Ruud) Department of Research and Development, Division of Mental Health Services, Akershus University
Hospital, 1478 Lorenskog, Norway.
(Ruud) Institute of Psychiatry, University of Oslo, Oslo, Norway.
Country of Publication
United Kingdom
Title
Mental health quality and outcome measurement and improvement in Norway.
Source
Current Opinion in Psychiatry. 22(6)(pp 631-635), 2009. Date of Publication: November
2009.
Publisher
Lippincott Williams and Wilkins
Abstract
PURPOSE OF REVIEW: To describe and discuss results from scientific articles in 20082009 on outcome and quality and improvement of these in the mental health services in
Norway. RECENT FINDINGS: Good outcome is documented for several types of
interventions and patient groups such as information campaigns to reduce duration of
untreated psychosis, dynamic psychotherapy with transference interpretations for patients
with less mature object relations, group and individual therapy for patients with personality
disorders, parent training to reduce conduct problems in small children and opioid
maintenance treatment to reduce deaths from overdose. At the same time, there is a lack of
adherence in clinicians' prescriptions of antipsychotic medication, in patients' use of
medication and of integrated treatment for psychiatric disorders and substance abuse.
General practitioners' rating of mental health services may be a more valid quality indicator
than patients' satisfaction. There is a lack of studies on quality, treatment fidelity, service
improvements and implementation of best practice. SUMMARY: In spite of some documented
treatments with good outcome, we know too little about the quality and outcome of the mental
health services. Strategies for implementation of evidence-based treatment accompanied by
research studies need to be the norm, not the exception. copyright 2009 Wolters Kluwer
Health | Lippincott Williams & Wilkins.
ISSN 0951-7367
Publication Type Journal: Review
Journal Name Current Opinion in Psychiatry
Volume 22
Issue Part 6
Page 631-635
Year of Publication 2009
Date of Publication November 2009