scholarly journals Implementation of a Multi-Modal Training Program for the Management of Comorbid Mental Disorders in Drug and Alcohol Settings: Pathways to Comorbidity Care (PCC)

2021 ◽  
pp. 1-9
Author(s):  
Eva Louie ◽  
Kirsten C. Morley ◽  
Vicki Giannopoulos ◽  
Gabriela Uribe ◽  
Katie Wood ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Training Program ◽  
Drug And Alcohol ◽  
Comorbid Mental Disorders

Neuropsychological profiles on the Weschler Adult Intelligence Scale (WAIS-IV) of individuals attending a long-term residential rehabilitation program for substance use problems

2021 ◽  
Author(s):  
Airlie Sullivan ◽  
Lauren Ann Monds ◽  
Warren Logge ◽  
Tristan Hurzeler ◽  
Kirsten Morley
Keyword(s):  
Mental Disorders ◽  
Processing Speed ◽  
Psychotic Disorders ◽  
Rehabilitation Program ◽  
Adult Intelligence Scale ◽  
Intelligence Scale ◽  
Verbal Comprehension ◽  
Residential Rehabilitation ◽  
Drug And Alcohol ◽  
Comorbid Mental Disorders

Background We aimed to examine the neuropsychological profiles on the Weschler Adult Intelligence Scale (WAIS-IV) of individuals attending a drug and alcohol rehabilitation program and determine the relationship between the multiple domains of cognitive functioning, comorbid mental disorders and treatment completion.Methods One hundred and ninety-six (N = 196) individuals from the Odyssey House Residential Rehabilitation Program, NSW, Australia between 2010-2016 were administered a structured interview including mental and substance use disorders and the Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI) domains of the WAIS-IV. Results Verbal Comprehension, Working Memory, and Processing Speed was below the mean relative to normative data derived from the standardisation of the WAIS-IV. Individuals with comorbid mental disorders also displayed significantly lower Verbal Comprehension relative to those without comorbid mental disorders (F = 4.56, p < 0.05). Comorbid psychotic disorders were particularly associated with poor Verbal Comprehension (p < 0.01). Treatment completion was significantly predicted by Verbal Comprehension (p < 0.05).Conclusions Verbal comprehension may be underlying poor treatment completion in drug and alcohol treatment rehabilitation settings. We also highlight an additional relationship between presence of comorbid psychotic disorders and poor verbal comprehension that may be of relevance in planning intervention programs during rehabilitation.

scholarly journals Comorbid mental disorders during long‐term course in a nationwide cohort of patients with anorexia nervosa

2021 ◽  
Author(s):  
Hans‐Christoph Steinhausen ◽  
Martin Dalgaard Villumsen ◽  
Kirsten Hørder ◽  
Laura Al‐Dakhiel Winkler ◽  
Niels Bilenberg ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Mental Disorders ◽  
Comorbid Mental Disorders

Falling out of Trains

1996 ◽  
Vol 40 (10) ◽  
pp. 501-505
Author(s):  
Stuart O. Parsons
Keyword(s):  
Mental Disorders ◽  
Training Program ◽  
Systems Engineering ◽  
Warning Sign ◽  
Dangerous Situation ◽  
The Us ◽  
Engineering Study ◽  
Exit Door ◽  
Passenger Trains ◽  
Interlock System

Approximately ten cases have been documented of people falling out of the side exit doors of moving passenger trains throughout the US. Most of these individuals were elderly passengers and the events usually happened late at night. Amtrak has classified most of these accidents as individuals with mental disorders or suicidal tendencies. Legal actions at the present time have been dismissed by the courts due primarily to the lack of any witnesses to the events. An investigation was conducted of a passenger car allegedly involved in one of these accidents. A number of recommendations were made including: 1) a systems engineering study of the problem, 2) an interlock system which would prevent the side exit door locking handle from being activated while the train is in motion, 3) an “All Green Board” at the engineer's station to indicate that all doors on the train are locked before starting the train, 4) a protective translucent cover installed over the regular door handle to indicate the criticality of opening this door, 5) a new warning sign on the exit doors which follows the ANSI standard, and 6) a training program, related to this dangerous situation, for all Amtrak operational personnel.

Process-outcome associations in an interdisciplinary treatment for chronic pain and comorbid mental disorders based on Acceptance and Commitment Therapy

Pain Medicine ◽  
2021 ◽  
Author(s):  
Ludwig Ohse ◽  
Ronald Burian ◽  
Eric Hahn ◽  
Hannah Burian ◽  
Thi Minh Tam Ta ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mental Disorders ◽  
Clinical Outcomes ◽  
Acceptance And Commitment Therapy ◽  
Psychological Flexibility ◽  
Post Treatment ◽  
Interdisciplinary Treatment ◽  
Pain Acceptance ◽  
Acceptance And Commitment ◽  
Comorbid Mental Disorders

Abstract Objective Numerous studies support the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain, yet little research has been conducted about its underlying mechanisms of change, especially regarding patients with comorbid mental disorders. The present investigation addressed this issue by examining associations of processes targeted by ACT (pain acceptance, mindfulness, psychological flexibility) and clinical outcomes (pain intensity, somatic symptoms, physical health, mental health, depression, general anxiety). Subjects Participants were 109 patients who attended an ACT-based interdisciplinary treatment program for chronic pain and comorbid mental disorders in a routine care psychiatric day hospital. Methods Pre- to post-treatment differences in processes and outcomes were examined with Wilcoxon signed-rank tests and effect size r. Associations between changes in processes and changes in outcomes were analyzed with correlation and multiple regression analyses. Results Pre- to post-treatment effect sizes were mostly moderate to large (r between |0.21| and |0.62|). Associations between changes in processes and changes in outcomes were moderate to large for both, bivariate correlations (r between |0.30| and |0.54|) and shared variances accounting for all three processes combined (R2 between 0.21 and 0.29). Conclusion The present investigation suggests that changes in pain acceptance, mindfulness and psychological flexibility are meaningfully associated with changes in clinical outcomes. It provides evidence on particular process-outcome associations that had not been investigated in this way before. The focus on comorbid mental disorders informs clinicians about a population of chronic pain patients that often has a severe course of illness and has seldom been studied.

scholarly journals Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0238137
Author(s):  
Ruth Tsigebrhan ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Charles R. Newton ◽  
Martin J. Prince ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Seizure Frequency ◽  
Functional Disability ◽  
Social Outcomes ◽  
Primary Health ◽  
Comorbid Mental Disorders

Background Evidence from high-income countries demonstrates that co-morbid mental disorders in people with epilepsy adversely affect clinical and social outcomes. However, evidence from low-income countries is lacking. The objective of this study was to measure the association between co-morbid mental disorders and quality of life and functioning in people with epilepsy. Methods A facility-based, community ascertained cross-sectional survey was carried out in selected districts of the Gurage Zone, Southern Ethiopia. Participants were identified in the community and referred to primary health care (PHC) clinics. Those diagnosed by PHC workers were recruited. Co-morbid mental disorders were measured using a standardised, semi-structured clinical interview administered by mental health professionals. The main outcome, quality of life, was measured using the Quality of Life in Epilepsy questionnaire (QOLIE-10p). The secondary outcome, functional disability, was assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-2). Results The prevalence of comorbid mental disorders was 13.9%. Comorbid mental disorders were associated with poorer quality of life (Adjusted (Adj.) β -13.27; 95% CI -23.28 to-3.26) and greater disability (multiplier of WHODAS-2 score 1.62; 95% CI 1.05, 2.50) after adjusting for hypothesised confounding factors. Low or very low relative wealth (Adj. β = -12.57, 95% CI -19.94 to-5.20), higher seizure frequency (Adj.β coef. = -1.92, 95% CI -2.83 to -1.02), and poor to intermediate social support (Adj. β coef. = -9.66, 95% CI -16.51 to -2.81) were associated independently with decreased quality of life. Higher seizure frequency (multiplier of WHODAS-2 score 1.11; 95% CI 1.04, 1.19) was associated independently with functional disability. Conclusion Co-morbid mental disorders were associated with poorer quality of life and impairment, independent of level of seizure control. Integrated and comprehensive psychosocial care is required for better health and social outcomes of people with epilepsy.

scholarly journals Performance of Primary Health Care Workers in Detection of Mental Disorders Comorbid with Epilepsy in Rural Ethiopia

2021 ◽  
Author(s):  
Ruth Tsigebrhan ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Charles R. Newton ◽  
Martin J. Prince ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Predictive Value ◽  
Rural Ethiopia ◽  
Primary Health ◽  
Clinical Records ◽  
Comorbid Mental Disorders ◽  
Screening Scale

Abstract Background: Timely detection and management of comorbid mental disorders in people with epilepsy is essential to improve outcomes. The objective of this study was to measure the performance of primary health care (PHC) workers in identifying comorbid mental disorders in people with epilepsy against a standardised reference diagnosis and a screening instrument in rural Ethiopia.Methods: People with active convulsive epilepsy were identified from the community, with confirmatory diagnosis by trained PHC workers. Documented diagnosis of comorbid mental disorders by PHC workers was extracted from clinical records. The standardized reference measure for diagnosing mental disorders was the Operational Criteria for Research (OPCRIT plus) administered by psychiatric nurses. The mental disorder screening scale (Self-Reporting Questionnaire; SRQ-20), was administered by lay data collectors. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PHC worker diagnosis against the reference standard diagnosis was calculated. Logistic regression was used to examine the factors associated with misdiagnosis of comorbid mental disorder by PHC workers. Results: A total of 237 people with epilepsy were evaluated. The prevalence of mental disorders with standardised reference diagnosis was 13.9% (95% confidence interval (CI) 9.6%, 18.2%) and by PHC workers was 6.3% (95%CI 3.2%, 9.4%). The prevalence of common mental disorder using SRQ-20 at optimum cut-off point (9 or above) was 41.5% (95% CI 35.2%, 47.8%). The sensitivity and specificity of PHC workers diagnosis was 21.1% and 96.1%, respectively, compared to the standardised reference diagnosis. In those diagnosed with comorbid mental disorders by PHC workers, only 6 (40%) had SRQ-20 score of 9 or above. When a combination of both diagnostic methods (SRQ-20 score ≥9 and PHC diagnosis of depression) was compared with the standardised reference diagnosis of depression, sensitivity increased to 78.9% (95% (CI) 73.4, 84.4%) with specificity of 59.7% (95% CI 53.2, 66.2%). Only older age was significantly associated with misdiagnosis of comorbid mental disorders by PHC (adjusted odds ratio, 95% CI= 1.06, 1.02 to 1.11).Conclusion: Routine detection of co-morbid mental disorder in people with epilepsy was very low. Combining clinical judgement with use of a screening scale holds promise but needs further evaluation.

scholarly journals Psychotic experiences and general medical conditions: a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys

2018 ◽  
Vol 48 (16) ◽  
pp. 2730-2739 ◽  
Author(s):  
Kate M. Scott ◽  
Sukanta Saha ◽  
Carmen C.W. Lim ◽  
Sergio Aguilar-Gaxiola ◽  
Ali Al-Hamzawi ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Mental Disorders ◽  
Severe Headache ◽  
Medical Conditions ◽  
Psychotic Experiences ◽  
World Mental Health ◽  
Wide Range ◽  
Comorbid Mental Disorders ◽  
Subsequent Onset

AbstractBackgroundPrevious work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders.MethodsIn total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments.ResultsAfter adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1–1.5] to 1.9 (95% CI 1.4–2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2–1.9) to 1.7 (95% CI 1.2–2.4).ConclusionsPEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.

Asthma and Suicidal Ideation Among Youth in the Community

Crisis ◽  
2004 ◽  
Vol 25 (3) ◽  
pp. 99-102 ◽  
Author(s):  
Renee D. Goodwin ◽  
Andrej Marušič
Keyword(s):  
Mental Health ◽  
United States ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Community Based ◽  
Comorbid Mental Disorders

Summary: Objective: To determine the association between asthma and suicidal ideation among youth in the community. Method: Data were drawn from the MECA (n = 1285), a community-based study of youth aged 9-17 in the United States. Multiple logistic regression analyses were used to determine the association between asthma and suicidal ideation, adjusting for differences in sociodemographic characteristics and mental disorders. Results: Asthma was associated with a significantly increased likelihood of suicidal ideation (OR = 3.25 ‘1.04, 10.1’), compared to youth without asthma. Conclusions: These data suggest that youth who are hospitalized for asthma may have higher than expected levels of suicidal ideation, compared with youth without asthma in the community. This association appears to persist after controlling for the effects of comorbid mental disorders. These findings are consistent with previous clinical reports of an association between physical illness and suicidal ideation, as well as with links between asthma and suicidal ideation among adults. More in-depth evaluation of the mental health of youth hospitalized for asthma may be indicated if these results are replicated.

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