The Impact of an Inpatient Treatment on the Psychodynamic and Symptomatology in Couples Concordant for Substance Use: A Qualitative Study

Abstract Background: Much literature is devoted to describing the psychosocial situation of patients with a substance use disorder and the course of their families and healthy partners. Couples where both partners have a substance use disorder are less well described and even less often studied. Method: This study described the psychodynamic and symptomatology, as measured by the Brief Symptom Inventory (BSI), of five concordant couples treated simultaneously as inpatients at the same specialized substance use disorder ward. Results: The psychodynamic characterization of the couples revealed that the female was often the organizer, whereas the male was either the motivator or the lackey. In addition, the female was often emotionally dependent on the male. Most individuals showed symptom reductions from pre- to post-treatment, although the men seemed to benefit to a greater extent than the women. Moreover, the patients did not necessarily desire couples therapy. Conclusion: Treating couples concordant for substance use together in the same inpatient setting is unusual, but possible. The dynamics of couples in drug rehabilitation should be further investigated taking into account possible gender differences.

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The Impact of an Inpatient Treatment on the Psychodynamic and Symptomatology in Couples Concordant for Substance Use: An Exploratory Study

10.21203/rs.2.19604/v2 ◽

2020 ◽

Author(s):

Aksel Hansen ◽

Stefan Brokatzky ◽

Benjamin Kraus ◽

Kai Thomas ◽

Christina Sternbauer ◽

...

Keyword(s):

Substance Use ◽

Exploratory Study ◽

Research Question ◽

Healthcare Services ◽

Structured Interview ◽

Brief Symptom Inventory ◽

The Body ◽

Inpatient Setting ◽

Individual Level ◽

The Impact

Abstract Background: Much literature deals with patients who use drugs and have partners who are drug-free. However, concordant couples, in which both partners are consuming drugs, are sparsely examined in the literature. This might be due to the fact, that couples are rarely treated together in healthcare services. Despite that fact we propose that it is feasible and clinically meaningful to treat concordant couples in the same ward. Consequently, this study pursues the goal to expand the body of knowledge in the treatment of concordant couples investigating the research question: is it feasible, clinically and prognostically meaningful to treat these patients in the same ward? Method: This exploratory study included five concordant couples (ten patients), which were simultaneously treated between August 2013 and November 2014 in a specialised substance use ward at the Psychiatric Hospital Münsterlingen, Switzerland. All patients passed through a psychodynamic characterisation based on the OPD-II interview and the Structured Interview for Personality Organization. Symptom load was measured with the Brief Symptom Inventory at admission and termination of treatment. We calculated comparisons at the individual level using t-tests for paired samples. Results: We showed that it is feasible and clinically meaningful to treat couples concordant for substance use in the same ward. The psychodynamic characterization of the five concordant couples revealed recurring patterns of collusion, involving divided roles between dependence and independence, caregiving and neediness, activity and passivity, control and submission, strength and deficiency as well as superiority and inferiority. The patients didn´t change significantly on the BSI between pre- to post-treatment, although men (d = 1.64) benefited to a greater extent than women (d = 0.10). Conclusion: Treating concordant couples together in the same inpatient setting is unusual, but feasible and clinically useful, because it makes it possible to take into account the couples dynamics in the treatment.

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The impact of substance use on treatment as a compulsory patient

Australasian Psychiatry ◽

10.1177/1039856219852286 ◽

2019 ◽

Vol 27 (4) ◽

pp. 378-382

Author(s):

Ruth Vine ◽

Holly Tibble ◽

Jane Pirkis ◽

Matthew Spittal ◽

Fiona Judd

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorder ◽

Inpatient Treatment ◽

Subsequent Treatment ◽

Community Treatment ◽

Main Diagnosis ◽

The Impact ◽

Treatment Order ◽

Community Treatment Order

Objectives: This paper considers the impact of having a diagnosis of substance use disorder on the utilisation of compulsory orders under the Victorian Mental Health Act (2014). Methods: We analysed the subsequent treatment episodes over 2 years of people who had been on a community treatment order for at least 3 months and determined the odds of a further treatment order if there was a diagnosis of substance use at or about the time the index community treatment order ended. Results: An additional diagnosis of a substance use disorder was coded in 47.7% and was associated with significantly increased odds of a subsequent treatment order in the following 2 years for those with a main diagnosis of schizophrenia (AOR = 3.03, p<0.001) and ‘other’ disorders (AOR = 11.60, p=0.002). Those with a main diagnosis of mood disorder had a significant increase in odds for an inpatient treatment order if there was an additional substance use disorder diagnosis (AOR = 3.81, p=0.006). Conclusions: Having an additional diagnosis of substance use disorder was associated with increased likelihood of being placed on an order. This study supports greater emphasis being given to treatment of substance use concurrently with that of mental illness.

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Factors affecting treatment motivation among Turkish patients receiving inpatient treatment due to alcohol/substance use disorder

Journal of Ethnicity in Substance Abuse ◽

10.1080/15332640.2018.1548324 ◽

2019 ◽

Vol 19 (4) ◽

pp. 594-609 ◽

Cited By ~ 2

Author(s):

Ozlem Kazan Kizilkurt ◽

Fikret Ferzan Gıynaş

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Inpatient Treatment ◽

Treatment Motivation ◽

Factors Affecting ◽

Turkish Patients

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Individual differences in the neuropsychopathology of addiction

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2017.19.3/gkoob ◽

2017 ◽

Vol 19 (3) ◽

pp. 217-229 ◽

Cited By ~ 14

Keyword(s):

Substance Use ◽

Individual Differences ◽

Substance Use Disorder ◽

Negative Reinforcement ◽

Incentive Salience ◽

Cognitive Profiles ◽

Pharmacological Treatments ◽

Brain Reward ◽

The Brain

Drug addiction or substance-use disorder is a chronically relapsing disorder that progresses through binge/intoxication, withdrawal/negative affect and preoccupation/anticipation stages. These stages represent diverse neurobiological mechanisms that are differentially involved in the transition from recreational to compulsive drug use and from positive to negative reinforcement. The progression from recreational to compulsive substance use is associated with downregulation of the brain reward systems and upregulation of the brain stress systems. Individual differences in the neurobiological systems that underlie the processing of reward, incentive salience, habits, stress, pain, and executive function may explain (i) the vulnerability to substance-use disorder; (ii) the diversity of emotional, motivational, and cognitive profiles of individuals with substance-use disorders; and (iii) heterogeneous responses to cognitive and pharmacological treatments. Characterization of the neuropsychological mechanisms that underlie individual differences in addiction-like behaviors is the key to understanding the mechanisms of addiction and development of personalized pharmacotherapy.

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Implementation of a Patient-Provider Agreement to Improve Healthcare Delivery for Patients With Substance Use Disorder in the Inpatient Setting

Journal of Patient Safety ◽

10.1097/pts.0000000000000721 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Alysse G. Wurcel ◽

Sun Yu ◽

Deirdre Burke ◽

Amy Lund ◽

Kim Schelling ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Healthcare Delivery ◽

Inpatient Setting

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A Motion-Activated Video Game for Prevention of Substance Use Disorder Relapse in Youth: Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.11716 ◽

2018 ◽

Author(s):

Lorien C Abroms ◽

Marc Fishman ◽

Hoa Vo ◽

Shawn C Chiang ◽

Victoria Somerville ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Video Game ◽

Addiction Treatment ◽

Intervention Group ◽

Body Motion ◽

Control Group ◽

Inpatient Setting ◽

Game Play ◽

Treatment As Usual

BACKGROUND Body motion-activated video games are a promising strategy for promoting engagement in and adherence to addiction treatment among youth. OBJECTIVE This pilot randomized trial (N=80) investigated the feasibility of a body motion–activated video game prototype, Recovery Warrior 2.0, targeting relapse prevention in the context of a community inpatient care program for youth. METHODS Participants aged 15-25 years were recruited from an inpatient drug treatment program and randomized to receive treatment as usual (control) or game play with treatment as usual (intervention). Assessments were conducted at baseline, prior to discharge, and at 4 and 8 weeks postdischarge. RESULTS The provision of the game play intervention was found to be feasible in the inpatient setting. On an average, participants in the intervention group played for 36.6 minutes and on 3.6 different days. Participants in the intervention group mostly agreed that they would use the refusal skills taught by the game. Participants in the intervention group reported attending more outpatient counseling sessions than those in the control group (10.8 versus 4.8), but the difference was not significant (P=.32). The game had no effect on drug use at 4 or 8 weeks postdischarge, with the exception of a benefit reported at the 4-week follow-up among participants receiving treatment for marijuana addiction (P=.04). CONCLUSIONS Preliminary evidence indicates that a motion-activated video game for addiction recovery appears to be feasible and acceptable for youth within the context of inpatient treatment, but not outpatient treatment. With further development, such games hold promise as a tool for the treatment of youth substance use disorder. CLINICALTRIAL ClinicalTrials.gov NCT03957798; https://clinicaltrials.gov/show/NCT03957798 (Archived by WebCite at http://www.webcitation.org/78XU6ENB4)

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Deceptive Dynamics in Drug Addiction and Their Role in Control Beliefs and Health Status Reporting: A Study on People With Substance Use Disorder in Treatment

Journal of Drug Issues ◽

10.1177/0022042619853299 ◽

2019 ◽

Vol 49 (4) ◽

pp. 575-592 ◽

Cited By ~ 3

Author(s):

Andrea Caputo

Keyword(s):

Substance Use ◽

Health Status ◽

Impression Management ◽

Substance Use Disorder ◽

Internal Control ◽

Treatment Success ◽

Control Beliefs ◽

Background Information ◽

Drug Rehabilitation ◽

Health Related

This study aims at exploring deceptive dynamics (i.e., impression management [IM], self-deception, and emotional manipulation [EM]) and their role in control beliefs and health status reporting in a sample of people treated for substance use disorder. Seventy-eight participants following drug rehabilitation treatment were recruited, who provided background information and completed measures of social desirability responding, EM, locus of control, and health-related status. Moderated-regression analyses and t tests were performed. The results highlight that self-deception is associated with not reporting the use of secondary substances and being in treatment for a shorter time period. IM appears as the main deceptive tendency able to account for internal control beliefs and better mental health. Some interaction effects emerge among the examined deceptive tendencies, which suggest to deepen the role of EM as a risk factor for drug relapse and treatment success.

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