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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