Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

2020 ◽  
Vol 54 (12) ◽  
pp. 1212-1223
Author(s):  
Cesare Cavalera ◽  
Clarissa Ferrari ◽  
Giorgio Bianconi ◽  
Viola Bulgari ◽  
Valentina Candini ◽  
...  
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Well Being ◽  
Community Safety ◽  
Aggressive Behaviors ◽  
Severe Mental Disorders ◽  
Violent Behaviour ◽  
Prospective Multicentre Study ◽  
Verbal Assault

Objective: The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. Methods: A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. Results: The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. Conclusion: These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and community safety.

scholarly journals Pre-Discharge Predictors of 1-Year Rehospitalization in Adolescents and Young Adults with Severe Mental Disorders: A Retrospective Cohort Study

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 613
Author(s):  
Francesco Bartoli ◽  
Daniele Cavaleri ◽  
Federico Moretti ◽  
Bianca Bachi ◽  
Angela Calabrese ◽  
...  
Keyword(s):  
Substance Use ◽  
Young Adults ◽  
Mental Disorders ◽  
Suicide Attempt ◽  
Mental Disorder ◽  
Regression Model ◽  
Substance Use Disorders ◽  
Cox Regression ◽  
Severe Mental Disorders ◽  
Severe Mental Disorder

Background and objectives: Readmissions of youths hospitalized for a severe mental disorder are common events and bear a remarkable human, social, and economic burden. The current study aimed at evaluating predictors of 1-year rehospitalization in a sample of adolescents and young adults with severe mental disorders. Materials and Methods: Data for ≤25-year-old inpatients with a severe mental disorder and consecutively admitted between 1 January 2016 and 30 June 2019 were collected. Subjects were retrospectively assessed over a follow-up period of one year after the index discharge to track readmissions—i.e., the primary outcome variable. Standard descriptive statistics were used. The association between variables and 1-year rehospitalization was estimated using the univariate Cox proportional hazards regression model. We then carried out a multivariable Cox regression model, also estimating the covariate-adjusted survivor function. Hazard ratios (HRs) with related 95% confidence intervals (95% CIs) were provided. Results: The final sample included 125 individuals. The multivariable Cox regression model estimated that co-occurring substance use disorders (HR = 2.14; 95% CI: 1.08 to 4.26; p = 0.029) and being admitted for a suicide attempt (HR = 2.49; 95% CI: 1.13 to 5.49; p = 0.024) were both significant predictors of 1-year rehospitalization. Conclusions: Our study showed that comorbid substance use disorders and being admitted for a suicide attempt were predictors of early readmission in youths with severe mental disorders. Although their generalizability is limited, our findings could contribute to improve the quality of young patients’ mental health care by identifying vulnerable subjects who may benefit from tailored interventions to prevent rehospitalizations.

scholarly journals Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

BJPsych Open ◽  
2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Rocco Micciolo ◽  
Giorgio Bianconi ◽  
Luisa Canal ◽  
Massimo Clerici ◽  
Maria Teresa Ferla ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Rating Scale ◽  
Age Groups ◽  
Anger Expression ◽  
Young Age ◽  
Severe Mental Disorders ◽  
Violent Behaviour ◽  
Specific Level ◽  
Prospective Multicentre Study ◽  
Social Settings

Background During adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings. Aims This prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups. Method A total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS). Results The sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P < 0.001). Conclusions This study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

Prevalence of Mental Disorders in Abakaliki, Ebonyi State, Southeastern Nigeria

2020 ◽  
pp. 107839032095191
Author(s):  
Njaka Stanley ◽  
Ezeruigbo S. Chinwe
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Significant Relationship ◽  
Well Being ◽  
Southeastern Nigeria ◽  
Economic Output ◽  
The People ◽  
Health Registry

Background: Increasing psychological stressors have posed challenges to the well-being of the people across the globe and greatly affected the functionality and economic output of the individuals and the society. Nigeria has no existing mental health registry. Data on the prevalence of mental disorders are not readily available owing to lack of mental health registry. Hence, this study assessed the prevalence of mental disorders in Abakaliki metropolis, Ebonyi State. Aim: To determine the prevalence of mental disorders and associated factors among the residents of Abakaliki metropolis, Ebonyi State. Method: This cross-sectional descriptive research study involved 400 participants. Questionnaires adapted from world mental health diagnostic interview and General Health Questionnaire 12 were used for data collection. Data were analyzed using descriptive statistics and hypotheses tested using chi-square test at significance level of .05. Results: The prevalence of mental disorders among the respondents was 70% depressive disorders and 52.3% substance use disorders—tranquilizers (34.9%) and stimulants (15.8%) were the commonly used, while 85.3% suffered anxiety disorders. These were common among age range of 19 to 28 years—those with higher education and the unemployed. More females had mental disorders except substance use disorders, which was higher in males (53.4%). There was no significant relationship between mental disorders and the demographic variables, but significant relationship was found to exist between individuals’ age and anxiety disorder. Conclusion: Mental disorders, such as depression, anxiety, and substance use disorders, are common among the respondents and, therefore, calls for urgent attention of the government to improve the mental health of the people.

Addiction and Violence Among People with Severe Mental Illnesses: An Updated Literature Review

2017 ◽  
Vol 41 (S1) ◽  
pp. S153-S153
Author(s):  
I. Khemiri ◽  
F. Fekih Romdhane ◽  
A. Belkhiria ◽  
J. Lamia ◽  
R. Trabelsi ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Mental Illness ◽  
Substance Use ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Mental Illnesses ◽  
Severe Mental Disorders ◽  
Co Morbidity

IntroductionViolence has important relevance for the criminal justice and health care systems especially forensic psychiatry. Previous studies reported the relation between violence, mental illness and substance abuse. We purpose to investigate the association between addiction and violence among people with severe mental illness through a review of literature.Methodwe conducted a Medline and Pubmed literature search of studies published between “2000 and 2015”, combining the terms “psychotic disorders”, “addiction” “substance use disorder”.ResultsThe studies published showed that much of the excessive violence observed in patients with severe psychiatric disorders is due to co-morbid substance use. Increasing violence associated with substance use disorders in these patients had same level than that observed among subjects without severe psychiatric disorders. Increasing violence in subjects with substance use disorder but without severe mental disorders was higher than in patients with only severe mental disorders. In fact, mental disorders could increase the risk of installing on substance use disorders, and therefore increase the risk of partner violence. Among the substances used, if alcohol is frequently identified as a consumer risk for the emergence of violence among subjects with severe psychiatric disorders, stimulants could be causing more violence than alcohol.ConclusionsSevere mental illnesses are associated with violence. However, most of the excess risk appears to be mediated by substance abuse co-morbidity. This finding improves the need of prevention of substance use disorders and emphasizes the fact that patients with severe mental disorders are more often victims than perpetrators of violence.

scholarly journals The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sidsel Karsberg ◽  
Morten Hesse ◽  
Michael Mulbjerg Pedersen ◽  
Ruby Charak ◽  
Mads Uffe Pedersen
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Psychological Trauma ◽  
Well Being ◽  
Traumatic Experiences ◽  
Treatment Entry ◽  
Trauma Types ◽  
Using Data ◽  
The Impact ◽  
Drug Use Disorder

Abstract Background It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. Methods Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. Results Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. Conclusion Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. Trial registration ISRCTN88025085, date of registration: 29.08.2016, retrospectively registered.

Attachment, Well-Being, and Religious Participation Among People with Severe Mental Disorders

2004 ◽  
Vol 7 (2) ◽  
pp. 13-25 ◽  
Author(s):  
Michele A. Schottenbauer ◽  
Roger D. Fallot ◽  
Christine L. Tyrrell
Keyword(s):  
Mental Disorders ◽  
Well Being ◽  
Religious Participation ◽  
Severe Mental Disorders

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

Frequent use of emergency departments for mental and substance use disorders

2018 ◽  
Vol 35 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Karen Urbanoski ◽  
Joyce Cheng ◽  
Jürgen Rehm ◽  
Paul Kurdyak
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Service Use ◽  
Secondary Analysis ◽  
Mental Healthcare ◽  
Specialist Care ◽  
Ed Visits ◽  
Administrative Health Databases

ObjectivesWe described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD.MethodsThis retrospective observational study included all Ontario residents 15 years and older who had five or more ED visits during any 12-month period from 2010 to 2012 (n=263 346). The study involved a secondary analysis of administrative health databases capturing emergency, hospital and ambulatory care. Frequent ED users for mental disorders (n=5416) were grouped into nested categories based on the number of ED visits for SUD. Logistic regression was used to examine group differences in the receipt of follow-up services and mortality, controlling for sociodemographics, comorbidities and past service use.ResultsThe majority of frequent ED users for mental disorders had at least one ED visit for SUD, most commonly involving alcohol. Relative to people with no visits for SUD, those with ED visits for SUD were older and more likely to be men (Ps <0.001). As the number of ED visits for SUD increased, the likelihood of receiving follow-up care, particularly specialist mental healthcare, declined while 2-year mortality steadily increased (Ps <0.001). These associations remained after controlling for comorbidities and past service use.ConclusionsFindings highlight disparities in the receipt of specialist care based on use of ED services for SUD, coupled with a greater mortality risk. There is a need for policies and procedures to help address unmet needs for care and to connect members of this vulnerable subgroup with services that are better able to support recovery and improve survival.

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