The dual-diagnosis concept used by Swedish social workers: limited validity upon examination using a structured diagnostic approach

2002 ◽  
Vol 17 (6) ◽  
pp. 363-365 ◽  
Author(s):  
Markus Heilig ◽  
Kaj Forslund ◽  
Marie Åsberg ◽  
Ulf Rydberg
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Psychiatric Symptoms ◽  
Treatment Plan ◽  
Population Sample ◽  
Diagnostic Procedures ◽  
Individual Treatment ◽  
Self Medication ◽  
Axis I

SummaryA co-existence of chemical dependence and other psychiatric syndromes is commonly referred to as “dual-diagnosis.” This categorization is commonly made by social workers in several European countries assigned the primary responsibility for the care of drug and alcohol dependence. Here, we examined the validity of this categorization through systematic, structured patient evaluation following a minimum of 3 weeks of abstinence from drugs and alcohol. Less than one-third of patients originally labelled as suffering from “dual-diagnosis” by the social services did in fact obtain any Axis I DSM IIIR diagnosis, and less than half of the patients had any psychiatric diagnosis other than dependence. Syndromes commonly discussed in the context of self-medication, i.e., unipolar depression and anxiety syndromes, were not over-represented compared to a population sample, while chronic psychoses and bipolar syndromes were highly significantly more common. We conclude that the dual-diagnosis concept, unless substantiated through stringent diagnostic procedures by psychiatrically trained personnel, may be of questionable utility in caring for patients presenting with psychiatric symptoms and substance dependence. A systematic individual evaluation in an alcohol- and drug-free state of sufficient duration is necessary to obtain a basis for an adequate individual treatment plan.

scholarly journals Dual Diagnosis as a Tool for Therapists and Social Workers

2017 ◽  
Vol 3 (3) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychoactive Substances

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.

scholarly journals Dual Diagnosis as a Tool for Therapists and Social Workers

2017 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychoactive Substances

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.

scholarly journals Dual Diagnosis and Treatment: The Experience of a Multiprofessional Team in Mental Health

2017 ◽  
Vol 41 (S1) ◽  
pp. S309-S310
Author(s):  
J. Jaber ◽  
J. Verissimo ◽  
J. Mendonça ◽  
M. Schwartz ◽  
S. Leite ◽  
...  
Keyword(s):  
Dual Diagnosis ◽  
Positive Impact ◽  
Treatment Plan ◽  
Family Therapist ◽  
Individual Treatment ◽  
Psychiatric Clinic ◽  
Moderate Physical Activity ◽  
Psychoactive Substances ◽  
Multiprofessional Team ◽  
General Practicioner

IntroductionThe work was developed with the people hospitalized in the period of 1 year in a psychiatric clinic in Rio de Janeiro city, Brazil. 175 patients who presented dual diagnosis were evaluated.ObjectivesThe research aims to know the distribution of the most frequent psychiatric diagnosis associated with the disorders for the use of psychoactive substances. The work also has as objective to assess the treatment of patients carrying these disorders so that there is a better efficiency of the individual treatment plan.MethodsThe work consisted of the evaluation of all patients who were admitted to the clinic in the period of 1 year, using the ICD-10 for the diagnosis of dual pathologies. All the patients were assessed by the multiprofessional team, composed by general practicioner, psychiatrist, psychologist, pharmaceutic, therapist in chemical dependence, family therapist and physiotherapist. The patients were treated with the use of psychopharms, cognitive behavioral psychotherapy, 12-step program, art therapy and moderate physical activity. Family members of all patients were also interviewed.ResultsIn the evaluation conducted by the team, it was found the following distribution of the most frequent diagnosis associated to disorder for the use of psychoactive substances: depression (26.3%), personality disorder (22.9%), bipolar disorder (22.3%), non-schizophrenic psychosis (12.6%), schizophrenia (9.1%), and other diagnosis (6.8%).ConclusionsThe formulation of the dual diagnosis provided a better approach of the patients on the part of the team, promoting the strengthening of the therapeutic bond and causing positive impact on the evolution of these disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Social Rehabilitation for Vagrants and Beggars Through Institutional Approach in Indonesia

2021 ◽  
Vol 6 (6) ◽  
pp. 13-22
Author(s):  
Yanuar Farida Wismayanti ◽  
Husmiati Yusuf ◽  
Alit Kurniasari ◽  
Aulia Rahman ◽  
Mery Ganti ◽  
...  
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Central Government ◽  
Population Sample ◽  
National Policy ◽  
Homeless People ◽  
Rehabilitation Services ◽  
Social Rehabilitation ◽  
Big Cities ◽  
The Government

The problem of vagrants and beggars is a fairly complex issue in big cities such as Jakarta, Bandung, Semarang, Surabaya, Medan, and Makassar. These big cities' charms have attracted the poor with low education levels and limited access to education, health, and skill development. Many service programs for the vagrants and beggars have been carried out, yet the problems related to the vagrants and beggars have never subsided. Quantitative and qualitative approach are used to determine how the condition of social rehabilitation services carried out for vagrants and beggars by the government and the community, the extent of their level of social functioning, and the role of social workers in social rehabilitation services. A population sample is a group of homeless people and beggars who receive social services in government institutions and community organisation. The sampling used was the purposive sampling method with a sample of 487 respondents in the six provinces, namely DKI Jakarta, West Java, East Java, Central Java, North Sumatra, and South Sulawesi. This research found that in the process of social rehabilitation services for vagrants and beggars, there are still differences in the service standards between institutions; limitations in human resources, including social workers; limited budget support; limited cooperation, and coordination between local government organizations at the provincial, regency/municipal, and central government along with related stakeholders. It conclude that the national policy platform related to the handling of vagrants and beggars needs to be the focus to overcome the complexity of the problems faced by this marginal group.

The Relationship of Metabolic and Endocrine Parameters with Associated Diseases in Diabetes Mellitus

2018 ◽  
Vol 69 (5) ◽  
pp. 1288-1291 ◽  
Author(s):  
Mariana Cornelia Tilinca ◽  
Sandor Pal ◽  
Zoltan Preg ◽  
Eniko Barabas Hajdu ◽  
Raluca Tilinca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Scoring System ◽  
Laboratory Tests ◽  
Treatment Plan ◽  
Individual Treatment ◽  
Diabetic Patients ◽  
Thyroid Disorders ◽  
Associated Diseases ◽  
Investigation Methods ◽  
Predictive Role

The most common comorbidities in patients with diabetes mellitus are cardiovascular diseases, obesity, dyslipidemia, thyroid disorders but other associated diseases may frequently occur. Laboratory tests are useful investigation methods that may reveal the subclinical manifestations of the disease but they are also essential for patient monitoring. The aim of the study was to assess laboratory parameters and associated diseases in diabetic subjects and to implement a scoring system with a predictive role in the evolution of the cases. Material and methods: The study group consisted of 195 subjects with documented type 1 or type 2 diabetes. About half of the cases were collected from the Procardia outpatient unit, and the rest were patients admitted to the Diabetology Clinic in T�rgu Mure�. The study was performed between January - June 2017. The results of the laboratory tests, as well as the information regarding comorbidities and treatment, was collected and patients� body mass index was calculated. Based on the clinical data, a scoring system, called Diabetes Complication Severity Index (DCSI) with a predictive role, was implemented. The diabetic outpatients presented significantly better carbohydrate metabolic balance compared to the hospitalized subjects. No significant differences could be observed regarding kidney function, hepatic status and lipid profile of the two subgroups of diabetic subjects. The most important comorbidity observed in both patient groups was arterial hypertension. The hospitalized diabetic subjects had significantly higher incidence of ischemic heart disease and significantly lower incidence of thyroid disorders compared to the outpatients. The DCSI scoring system revealed that comorbidities are more frequently present in the hospitalized patients compared to the ambulant diabetic subjects. Evaluation of clinical status and laboratory results in diabetic patients followed by implementation of a scoring system based on the data obtained regarding comorbidities could help clinicians to set up an individual treatment plan for these patients, focusing on preventing other complications.

scholarly journals Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

2021 ◽  
Author(s):  
Sonja Rahim-Wöstefeld ◽  
Dorothea Kronsteiner ◽  
Shirin ElSayed ◽  
Nihad ElSayed ◽  
Peter Eickholz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Tooth Loss ◽  
Treatment Plan ◽  
Periodontal Therapy ◽  
Outcome Variable ◽  
Individual Treatment ◽  
Risk Indicator ◽  
Related Factors ◽  
Prognostic Tool

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

Modes of Relational Agency among Welfare-reliant Mothers

2021 ◽  
Author(s):  
Hagit Sinai-Glazer ◽  
Boris H J M Brummans
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Present Article ◽  
Social Services ◽  
Human Agency ◽  
Relational Agency ◽  
Research Participants ◽  
Seeking Help ◽  
Depth Interviews

Abstract How do welfare-reliant mothers enact their agency in relationships with social workers and social services? The present article addresses this question by investigating how twenty Israeli welfare-reliant mothers expressed different modes of human agency in in-depth interviews. Results show how research participants enact agency through (i) expressing anger, (ii) seeking help, (iii) resisting and (iv) engaging in non-action. By highlighting the multidimensional and situational nature of agency, this article offers a new relational lens for conceptualising and empirically studying human agency in social work.

Parenting in migration: Critical aspects and challenges of “doing family” of refugee families and social workers

2021 ◽  
pp. 146801732110146
Author(s):  
Nadia Rania ◽  
Laura Pinna ◽  
Ilaria Coppola
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Host Community ◽  
Cultural Barriers ◽  
Family Identity ◽  
Helping Relationship ◽  
Refugee Families ◽  
Job Opportunities ◽  
Migrant Families ◽  
Italian Context

Summary Although migrant families comprise a small number of immigrants, they present a significant challenge for the host community. In the Italian context, social services support migrant families through paths to autonomy and integration in the community. The purpose of this study was to investigate perceptions that families and social workers have of “parenting” and “doing family” (training and management of family identity, roles and daily practices) in the complexity of migration. The study involved 15 immigrant parental couples, using family interview techniques and 12 social workers in 3 mini-focus groups. The collected materials were transcribed verbatim and analyzed using grounded theory. Findings The main results are identified and discussed as strengths, critical points and challenges. Some of the themes such as “willingness to work” or “lack of job opportunities” are common to both family members and social workers. Other themes are relevant to one group only. Among these, “availability and support of social workers” only emerged among families, whereas “education and respecting the rules” only emerged among social workers. Applications The results indicate that it is necessary for social workers to engage in a meaningful helping relationship with families, build networks of inclusion services, and also with the support of mediators overcome linguistic and cultural barriers. Social workers should involve families throughout he integration process. Furthermore, social services must also consider how families experience the difficulty of relating to social workers, which represents an obstacle to support for social integration.

scholarly journals “When we talk about intimate partner violence we talk in an adult way” – Social workers’ descriptions of intimate partner violence between teenagers

2021 ◽  
pp. 147332502110028
Author(s):  
Emmy Högström Tagesson ◽  
Carina Gallo
Keyword(s):  
Intimate Partner Violence ◽  
Social Workers ◽  
Social Services ◽  
Partner Violence ◽  
Qualitative Interviews ◽  
Intimate Partner ◽  
Treatment Quality ◽  
Age And Gender ◽  
The Social ◽  
And Gender

This article examines how seven social workers within the Swedish social services describe intimate partner violence between teenagers (IPV-BT). The article adds to the literature by examining IPV-BT outside a U.S. context, where most studies have been conducted. Based on semistructured qualitative interviews, the authors analyze descriptions of IPV-BT in relation to Charles Tilly’s notion of category making through transfer, encounter, negotiation, and imposition. They also analyze how the social workers’ descriptions of IPV-BT relate to the intersection between age and gender. The results show that the social workers mostly described IPV-BT by referring to encounters with teenagers and by transferring knowledge and theoretical definitions from their specialized working areas, primarily intimate partner violence between adults (IPV-BA) and troubled youth. More rarely, the social workers based their definitions of IPV-BT upon negotiating dialogues with teenagers. Also, those who worked in teams specialized on IPV had the mandate to impose their definitions of IPV-BT to other professionals and teenagers. When taking age and gender hierarchies in consideration, the results show IPV-BT risks being subordinate IPV-BA on a theoretical level, a practical level and in terms of treatment quality. The study suggests that social work with IPV-BT needs to be sensitive to the double subordinations of the teenage girl and of the teenagers who do not follow gender expectations.

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