Severe Psychopathology and Substance Use Disorder Modify the Association between Housing Trajectories and Food Security among Homeless Adults

2020 ◽  
Author(s):  
James Lachaud ◽  
Cilia Mejia-Lancheros ◽  
Ri Wang ◽  
Michael Liu ◽  
Rosane Nisenbaum ◽  
...  

Abstract Background We examined the housing trajectories of homeless people with mental illness over a follow-up period of 6 years, and the association of these trajectories with food security. We then examined the modifying role of psychopathology and alcohol and substance use disorders in this association.Methods We followed 487 homeless adults with mental illness at the Toronto site of the At Home/Chez-Soi project –a randomized trial of Housing First. Housing data were collected every 3 months (Phase I) or 6 months (Phase II) during follow-up. Food security data were collected 7 times during the follow-up period. Psychopathology (Colorado Symptom Index score) and alcohol and substance use disorders were assessed at baseline. Housing trajectories were identified using group-based trajectory modelling. Logistic regression was used to estimate the association between housing trajectory groups and food security.Results Three housing trajectory groups were identified: a rapid move to consistent stable housing (34.7%), slow and inconsistent housing (52.1%), and never moved to stable housing (13.2%). Individuals included in the rapid move to consistent housing trajectory group had higher odds of remaining food secure compared to those in the never moved to stable housing trajectory group over the follow-up period [AOR 2.9, 95% CI: 1.3–6.6, P-value: 0.009]. However, when interactions were considered, this association was significant among those with moderate psychopathology but not severe psychopathology. Individuals with substance use disorder and in the group never move to stable house group had the lowest food security status.Conclusion Severe psychopathology and substance use disorders modified the association between housing trajectories and food security. Housing interventions need to focus on long term housing stability as well as food security, especially among those with severe psychopathology and substance use disorder.Ethical considerations The Toronto AH/CS study received approval from the St. Michael’s Hospital Research Ethics Board (Canada), and all participants gave informed written consent to participate in the AH/CS study. The AH/CS study is also registered with the International Standard Randomized Control Trial Number Register (ISRCTN42520374).

2021 ◽  
Vol 8 ◽  
Author(s):  
James Lachaud ◽  
Cilia Mejia-Lancheros ◽  
Michael Liu ◽  
Ri Wang ◽  
Rosane Nisenbaum ◽  
...  

Purpose: We examined the housing trajectories of homeless people with mental illness over a follow-up period of 6 years and the association of these trajectories with food security. We then examined the modifying role of psychopathology and alcohol and substance use disorders in this association.Materials and Methods: We followed 487 homeless adults with mental illness at the Toronto site of the At Home/Chez-Soi project—a randomized trial of Housing First. Food security data were collected seven times during the follow-up period. Psychopathology (Colorado Symptom Index score) and alcohol and substance use disorders were assessed at baseline. Housing trajectories were identified using group-based trajectory modeling. Logistic regression was used to estimate the association between housing trajectory groups and food security.Results: Three housing trajectory groups were identified: rapid move to consistent stable housing (34.7%), slow and inconsistent housing (52.1%), and never moved to stable housing (13.2%). Individuals included in the rapid move to consistent housing trajectory group had higher odds of remaining food secure compared with those in the never moved to stable housing trajectory group over the follow-up period [AOR 2.9, 95% CI: 1.3–6.6, P-value: 0.009]. However, when interactions were considered, this association was significant among those with moderate psychopathology but not severe psychopathology. Individuals with substance use disorder and in the never moved to stable housing group had the lowest food security status.Discussion: Severe psychopathology and substance use disorders modified the association between housing trajectories and food security.International Standard Randomized Control Trial Number Register (ISRCTN42520374).


2021 ◽  
Vol 10 (2) ◽  
pp. 264
Author(s):  
Pauline M. Geuijen ◽  
Sophie J. M. van den Broek ◽  
Boukje A. G. Dijkstra ◽  
Joanneke M. Kuppens ◽  
Hein A. de Haan ◽  
...  

In the past decades, monitoring programs have been developed for healthcare professionals with substance use disorders. We aimed to explore estimates of abstinence and work retention rates after participation in such monitoring programs. A literature search was performed using PubMed, Embase, PsycINFO, and CINAHL. Twenty-nine observational studies reporting on success rates (abstinence and work retention) of monitoring for healthcare professionals with a substance use disorder were included in the meta-analysis. Quality-effects models calculated pooled success rates and corresponding 95%-Confidence Intervals (CI), with subgroup analyses on monitoring elements and patient characteristics. Pooled success rates were 72% for abstinence (95%-CI = 63–80%) and 77% for work retention (95%-CI = 61–90%). Heterogeneity across studies was partly explained by the starting moment of monitoring, showing higher abstinence rates for studies that started monitoring after treatment completion (79%; 95%-CI = 72–85%) compared to studies that started monitoring with treatment initiation (61%; 95%-CI = 50–72%). About three-quarters of healthcare professionals with substance use disorders participating in monitoring programs are abstinent during follow-up and working at the end of the follow-up period. Due to selection and publication bias, no firm conclusions can be drawn about the effectiveness of monitoring for healthcare professionals with SUD.


2021 ◽  
Vol 9 (3) ◽  
pp. 264-272
Author(s):  
S.F. Agberotimi ◽  
C. Oduaran

Objective: This study investigated the efficacy of meaning-centred therapy (MCT) in the management of substance use disorders (SUD) in Nigeria. Methods: A pre-test post-test control group experimental study was conducted among young individuals with substance use disorders.  Participants were purposively selected and randomly assigned to treatment (MCT) and control groups. Participants' mean age was 22.05±2.14 years. Assessments of both groups were done at intake, immediately after completion of the therapy (which is 10-weeks), and at 1-month follow-up. Independent-sample t-test and one-way repeated measure of analysis of variance were used for analyses at 0.05 significant level. Result: Individuals in the MCT group reported significantly lower substance use disorder symptoms compared to those in the control group. There was an overall significant difference between the SUD means of participants that received MCT at pre-test, post-test, and 1-month follow-up. Conclusion: It was concluded that MCT provided effective treatment of substance use disorder among the Nigerian population; its utilization is therefore recommended.  


2016 ◽  
Vol 10 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Claire Kullack ◽  
Jonathan Laugharne

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.


2008 ◽  
Vol 6 (3) ◽  
pp. 358-365 ◽  
Author(s):  
Joseph Biederman ◽  
Michael C. Monuteaux ◽  
Thomas Spencer ◽  
Timothy E. Wilens ◽  
Heather A. MacPherson ◽  
...  

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