Substance misuse and risk of aggression and offending among the severely mentally ill

1998 ◽  
Vol 172 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Helen Scott ◽  
Sonia Johnson ◽  
Paulo Menezes ◽  
Jonathan Bindman ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Substance Use ◽  
Inner City ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Substance Misuse ◽  
Community Treatment ◽  
Dually Diagnosed ◽  
Psychotic Illness ◽  
Severely Mentally Ill ◽  
History Of

BackgroundThe aim of this study was to investigate whether ‘dual diagnosis' (substance misuse and severe mental illness) is associated with aggression and offending.MethodTwenty-seven people meeting the criteria for both psychotic illness and a substance use disorder and 65 people with psychosis only were interviewed. Case notes were also examined and key workers asked to rate substance misuse and aggression.ResultsThe severity of aggression and offending among this community treatment sample was low. Individuals with a dual diagnosis were significantly more likely than those with psychosis only to report any history of committing an offence (P=0.001), or recent hostile behaviour (P=0.001). Keyworkers were more likely to report recent aggression among the dually diagnosed (P=0.01). Significant differences persisted when we used logistic regression to control for potentially confounding demographic and clinical variables.ConclusionsDual diagnosis may be an important factor in aggression and offending among severely mentally ill individuals in inner-city areas. Accurate risk assessment requires examination of substance use.

scholarly journals Substance misuse in the severely mentally ill

1996 ◽  
Vol 2 (3) ◽  
pp. 117-124 ◽  
Author(s):  
Roch Cantwell ◽  
Glynn Harrison
Keyword(s):  
Mental Illness ◽  
American Literature ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Substance Misuse ◽  
Research Interest ◽  
Common Occurrence ◽  
Precise Nature ◽  
Severely Mentally Ill ◽  
The Relationship

Comorbidity and dual diagnosis have a fashionable, and thus ephemeral, ring that belies their relevance to day-to-day practice. The topic has been increasingly addressed in North American literature where there is a recognition of the extent of substance misuse in the severely mentally ill, and the need to find ways of effectively managing its consequences. Substance misuse may colour the diagnosis, management and prognosis of major mental illness and can adversely affect the relationship between staff and patients. Despite its common occurrence, it frequently remains undetected (Ananth et al, 1989). With burgeoning research interest, there is some consensus as to how to manage the problem, but, as yet, little agreement on the precise nature of causal relationships.

Do community mental health teams caring for severely mentally ill patients adjust treatments and services based on patients’ antisocial or criminal behaviours?

2009 ◽  
Vol 24 (6) ◽  
pp. 373-379 ◽  
Author(s):  
S. Hodgins ◽  
A. Cree ◽  
F. Khalid ◽  
K. Patel ◽  
R. Sainz-Fuentes ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Aggressive Behaviour ◽  
Service Use ◽  
Substance Misuse ◽  
Illicit Drug ◽  
Antisocial Behaviour ◽  
Positive Symptoms ◽  
Severely Mentally Ill

AbstractBackgroundAntisocial behaviour is common among patients with severe mental illness (SMI) requiring hospitalisation.AimTo determine whether differential treatments and services are provided to patients with SMI who engage in antisocial behaviour.MethodA random sample of 161 inpatients with SMI were recruited from general adult wards and assessed at baseline and two years later. Information on symptoms, aggressive behaviour, substance misuse, and service use was obtained from patients and clinical files.ResultsPast antisocial behaviours were not associated with type or intensity of treatments and services. Severity of positive symptoms, aggressive behaviour, and illicit drug use were positively associated with the frequency of CMHT contact, but not with the type of CMHT, type of medication, or other treatments and benefits.ConclusionsWhile the frequency of meetings with CMHTs increased with the severity of antisocial behaviours, no specific treatments were provided to patients with SMI engaging in antisocial behaviours.

scholarly journals Birmingham community mental health team for the homeless

1997 ◽  
Vol 21 (2) ◽  
pp. 74-76 ◽  
Author(s):  
Martin Commander ◽  
Sue Odell ◽  
Sashi Sashidharan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mentally Ill ◽  
First Year ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Severely Mentally Ill ◽  
Homeless Mentally Ill ◽  
History Of

Mental health services have been criticised for failing to respond to the needs of the rising number of homeless mentally ill. We report on the first year of referrals to a community mental health team established to meet the needs of the severely mentally ill homeless in Birmingham. Most users had a psychotic disorder and a lengthy history of unstable housing, and experienced a range of other disadvantages. Although the team is successfully reaching its priority group, examination of other characteristics of users has highlighted a number of issues which should inform the future planning and development of the service.

scholarly journals Medication Adherence among Mentally Ill Patients with comorbid- Substance Use Disorder

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 602-609
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Md Faruk Hossain ◽  
Md Waziul Alam Chowdhury ◽  
Anwara Begum
Keyword(s):  
Substance Use ◽  
Medication Adherence ◽  
Mentally Ill ◽  
Substance Misuse ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Psychiatric Medication ◽  
Cross Sectional ◽  
Care Givers

Substance misuse is usually associated with poorer psychiatric medication adherence among mentally ill patients. Identifying proportion & predictors of medication adherence among patients with dual psychiatric and substance misuse problems is important because poor adherence is associated with relapse and re-hospitalization. This study was a descriptive cross sectional study conducted among the patients dually diagnosed with psychiatric and substance use disorders attending OPD in a tertiary care hospital of Dhaka city, during the period from May 2013 to November 2013. The main objective of the study was to explore the proportion of psychotropic medication adherence among the respondents who were on such medication for at least last 6 months (N=151). Respondents were selected purposefully. An informed consent was taken from the patients or care givers and data were collected using the questionnaire designed by the researcher based on Factors Influencing Neuroleptic Medication Taking Scale (FNIMTS). Diagnoses were done previously according to DSM-IV TR by psychiatrist appointed in inpatient and outpatient department. Questionnaire was filled up by the researcher by interviewing the patients and attending care givers as needed. Over half of the respondents (57.0%) admitted they had missed taking their medications on more than one occasion in the week prior to the interview. Thus this study found the proportion of medication adherence to be 43% among the respondents.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 602-609

scholarly journals Setting up an assertive community treatment service

1996 ◽  
Vol 2 (4) ◽  
pp. 143-150 ◽  
Author(s):  
Andrew Kent ◽  
Tom Burns
Keyword(s):  
Assertive Community Treatment ◽  
Mentally Ill ◽  
Revolving Door ◽  
Community Treatment ◽  
Treatment Service ◽  
Flexible Support ◽  
Severely Mentally Ill ◽  
Functional Areas ◽  
Key Worker

The last 20 years have witnessed a surge of interest in assertive community treatment (ACT) for the severely mentally ill (Drake & Burns, 1995). ACT aims to help people who would otherwise be in and out of hospital on a ‘revolving door’ basis live in the community and enjoy the best possible quality of life. Services based on the ACT model seek to replace the total support of the hospital with comprehensive, intensive and flexible support in the community, delivered by an individual key worker or core services team. They are organised in a way that optimises continuity of care across different functional areas and across time.

scholarly journals Changes in diagnoses before admission to a specialist medium secure unit

2012 ◽  
Vol 36 (11) ◽  
pp. 404-408 ◽  
Author(s):  
Amrith Shetty ◽  
Dilum Jayawickrama ◽  
Pamela J. Taylor
Keyword(s):  
Substance Misuse ◽  
Service Providers ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Psychotic Illness ◽  
Violent Behaviour ◽  
Medium Security ◽  
History Of ◽  
Secure Unit ◽  
Study Participants

Aims and methodThere is evidence that changing diagnoses may be an important factor preceding homicide, but there is little literature on diagnostic antecedents to admission to specialist secure units after violent behaviour. Our aim was to establish the frequency of a history of changing diagnoses in patients in a UK specialist unit, and to explore the characteristics of these patients.ResultsIn total, 38 of 42 study participants had prior contact with psychiatric services. Just over 40% (16 of the 38) had had their diagnosis changed three or more times. All those who had major changes in their diagnosis had received a diagnosis of a psychotic illness at some point prior to the secure unit admission, but then had it withdrawn, only to be restored after prolonged assessment in the secure unit. Personality disorder and substance misuse comorbidity was common in this group; however, non-psychotic diagnoses were seen as more important than psychotic diagnoses by general services.Clinical implicationsChanges in diagnosis between first presentation to psychiatric services and admission to a medium-security unit were more common than would be expected from reports in the general literature. They are a testimony to the difficulties experienced by service providers in delivering a consistent service. This needs to be studied further.

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