scholarly journals A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital

2012 ◽  
Vol 18 (2) ◽  
pp. 8 ◽  
Author(s):  
Anusha Lachman ◽  
Rene Nassen ◽  
Sue Hawkridge ◽  
Robin A Emsley
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Dual Diagnosis ◽  
Chart Review ◽  
Psychotic Disorders ◽  
Drugs Of Abuse ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
Retrospective Chart Review ◽  
First Episode

<p><strong>Background.</strong> A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD), which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services.</p><p><strong>Objective.</strong> There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations.</p><p><strong>Method.</strong> A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD) was recorded.<strong> </strong></p><p><strong>Results.</strong> Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine), and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages), risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described.</p><p><strong>Conclusions.</strong> This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual diagnosis presenting to a psychiatric facility. We aim to influence role-players to provide more integrated services, and highlight the need for future prospective studies in this adolescent group to assist in improving outcomes.</p>

scholarly journals Psychopathology in Substance Use Disorder Patients with and without Substance-Induced Psychosis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Simon Zhornitsky ◽  
Andràs Tikàsz ◽  
Élie Rizkallah ◽  
Jean-Pierre Chiasson ◽  
Stéphane Potvin
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Chart Review ◽  
Psychotic Disorders ◽  
Retrospective Chart Review ◽  
Psychotic Symptoms ◽  
Psychoactive Substances ◽  
Rehabilitation Centre ◽  
Sociodemographic Variables ◽  
Psychotomimetic Effects

Background. Substance-induced psychotic disorder (SIPD) is a diagnosis constructed to distinguish substance-induced psychotic states from primary psychotic disorders. A number of studies have compared SIPD persons with primary psychotic patients, but there is little data on what differentiates substance use disorder (SUD) individuals with and without SIPD. Here, we compared psychopathology, sociodemographic variables, and substance use characteristics between SUD patients with and without SIPD.Methods. A retrospective chart review was conducted on newly admitted patients at a rehabilitation centre between 2007 and 2012.Results. Of the 379 patients included in the study, 5% were diagnosed with SIPDn=19and 95% were diagnosed with SUDs without SIPDn=360. More SIPD patients reported using cannabis and psychostimulants, and fewer SIPD patients reported using alcohol than SUDs patients without SIPD. SIPD patients scored higher on the “schizophrenia nuclear symptoms” dimension of the SCL-90R psychoticism scale and exhibited more ClusterB personality traits than SUD patients without SIPD.Discussion. These data are consistent with previous studies suggesting that psychopathology, substance type, and sociodemographic variables play important role in the development of SIPD. More importantly, the results highlight the need for paying greater attention to the types of self-reported psychotic symptoms during the assessment of psychotomimetic effects associated with psychoactive substances.

Reducing AIDS and Substance Abuse Risk Factors Among Homeless, HIV-Infected, Drug-Using Persons

2000 ◽  
Vol 10 (1) ◽  
pp. 15-33 ◽  
Author(s):  
J. Richard Lewis ◽  
David P. Boyle ◽  
Linda S. Lewis ◽  
Maestro Evans
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Substance Use ◽  
High Risk ◽  
Treatment Program ◽  
Chart Review ◽  
Day Treatment ◽  
Retrospective Chart Review ◽  
Day Treatment Program ◽  
Abuse Risk

Objective: The impact of a comprehensive HIV education, housing support, and 12-step recovery program in a day treatment program for homeless persons infected with HIV was studied. Method: Participants' knowledge of HIV and substance abuse risk factors was assessed for a group of new clients and for a group of clients enrolled for 3 months using an author-developed questionnaire. Continuation of high-risk sexual and substance use behaviors was assessed using the approach. Success in maintaining housing and 12-step recovery was assessed using a retrospective chart review on a separate group of past participants. Results: Statistically significant positive changes in participants' knowledge of HIV and substance use and a decrease in self-reported high-risk behaviors were found. The retrospective chart review also indicated positive changes in housing stability and substance abuse recovery. Conclusions: Preliminary results support the conclusion that the day treatment program had positive effects on the three variables of concern.

The Role of Controlled Substance Use in Diversion Outcomes Among Mentally Ill Offenders: A Pilot Study

2017 ◽  
Vol 62 (9) ◽  
pp. 2709-2725
Author(s):  
Jennifer K. Boland ◽  
Barry Rosenfeld
Keyword(s):  
New York ◽  
Substance Abuse ◽  
Substance Use ◽  
Psychotic Disorders ◽  
Mentally Ill Offenders ◽  
Program Participation ◽  
Diversion Programs ◽  
Diversion Program ◽  
Drug History

Diversion programs offer opportunities to offenders with substance abuse or mental illness to attend treatment as an alternative to incarceration. The present study identified variables associated with drug relapse and recidivism and the moderating role of substance use on recidivism in a diversion sample. Data were collected from 80 clients with psychotic disorders from a diversion program in New York City. Outcomes were examined after 6 and 12 months of program participation. Individuals who used controlled substances other than alcohol or cannabis were more likely to have a positive toxicology result than those who used alcohol or cannabis only or those with no alcohol/drug history. Individuals with schizoaffective disorder were more likely to be rearrested than individuals with other diagnoses, as were those with a violent offense (e.g., assault, robbery). Positive toxicology results were unrelated to rearrest and did not moderate recidivism, suggesting substance abuse may be only indirectly related to rearrest among diverted offenders.

Impulsivity in early psychosis: A complex link with violent behaviour and a target for intervention

2018 ◽  
Vol 49 ◽  
pp. 30-36 ◽  
Author(s):  
V. Moulin ◽  
P. Golay ◽  
J. Palix ◽  
P.S. Baumann ◽  
M-M. Gholamrezaeec ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Early Intervention ◽  
Psychotic Disorders ◽  
Interaction Analysis ◽  
Early Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Violent Behaviour ◽  
Increased Risk ◽  
Early Intervention In Psychosis

AbstractBackgroundViolent behaviour (VB) occurs in first episode of schizophrenia and can have devastating impact both on victims and patients themselves. A better knowledge of the underlying mechanisms of VB may pave the way to preventive treatments.Objectives1) To explore the nature of the link between impulsivity and VB in early psychosis (EP) patients; 2) To explore the interactions between impulsivity and substance abuse, insight, and positive symptoms, the main dynamic risk factors of VB described to date.Design and methodsPost hoc analysis of data acquired in the frame of a 36-months EP cohort study. A total of 265 EP patients, aged 18 to 35, treated at TIPP (Treatment and early Intervention in Psychosis Program), at the Department of Psychiatry in Lausanne, Switzerland, were included in the study. Logistic regression analyzes were performed as well as mediation analysis and interaction analysisResultsOur data suggest that impulsivity is a predictor of VB when analyzed independently and as part of a multi-factorial model. Impulsivity continues to differentiate violent patients from non-violent ones at the end of the program. In addition, the relationship between impulsivity and VB is not mediated by substance abuse. Finally, the effect of impulsivity on the probability of VB is potentiated by the interaction of different levels of insight and positive symptoms.ConclusionsEarly intervention strategies in psychotic disorders should include evaluation of impulsivity considering it is linked to increased risk of VB and may respond to treatment.

Five-year Course of Bipolar Disorder Following Treatment of First Manic Episode with Risperidone Versus Olanzapine: A Retrospective Review

2017 ◽  
Vol 41 (S1) ◽  
pp. S206-S206
Author(s):  
K. Kulkarni ◽  
G. Devasthali ◽  
A. Purty ◽  
M. Kesavan ◽  
J. Reddy ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Retrospective Chart Review ◽  
Mood Stabilizer ◽  
Manic Episode ◽  
Complete Recovery ◽  
Mood Stabilizers ◽  
First Episode ◽  
Second Generation Antipsychotics ◽  
Icd 10 ◽  
Competing Interest

ObjectiveContemporary treatment guidelines recommend use of second-generation antipsychotics (SGAs) either as mono therapy or in combination with mood stabilizers as first-line treatment. While these drugs have been established to have superior efficacy compared to placebo, there is very less data comparing these antipsychotics with one another. We sought to study differences in the five-year outcome of first episode of mania (FEM) treated with olanzapine or risperidone, either alone or in combination with mood stabilizer.MethodsWe conducted a retrospective chart review of patients diagnosed with FEM (ICD-10) in the year 2008 (n = 88) at our centre. We selected the data of patients prescribed either olanzapine or risperidone for the purpose of this analysis. We extracted data about time to recovery and recurrence after FEM, total episodes, drug compliance and response, and number of follow-up visits from 2008 to 2013. The study was approved by the Institute Ethics Committee.ResultsA total of 88 patients received diagnosis of FEM in the year 2008, of which 50 (56.8%) received risperidone and 35 (39.8%) received olanzapine. The two groups were comparable in socio-demographic and clinical symptomatology of FEM (all P > 0.08). Complete recovery was significantly more in the olanzapine group than the risperidone group (χ2 = 4.84, P < 0.05).ConclusionOur study indicates that risperidone and olanzapine, either alone or in combination with mood stabilizers have a similar impact on the five-year course of BD following a first manic episode. However, olanzapine is associated with more complete recovery from FEM than risperidone.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Interrelated Effects of Substance Use Diagnosis, Race, and Smoking Severity on Abstinence Initiation in Dually Dependent Male Smokers: Results of a Retrospective Chart Review

2007 ◽  
Vol 1 (4) ◽  
pp. 191-197 ◽  
Author(s):  
Jaimee L. Heffner ◽  
Thomas J. Blom ◽  
Elaine Camerota ◽  
Linda E. Sansone ◽  
Linda Bodie ◽  
...  
Keyword(s):  
Substance Use ◽  
Chart Review ◽  
Retrospective Chart Review

scholarly journals What are kids getting into these days? A retrospective chart review of substance use presentations to a Canadian pediatric emergency department

CJEM ◽  
2015 ◽  
Vol 17 (4) ◽  
pp. 345-352 ◽  
Author(s):  
G. Emmi Driedger ◽  
Kathryn A. Dong ◽  
Amanda S. Newton ◽  
Rhonda J. Rosychuk ◽  
Samina Ali
Keyword(s):  
Emergency Department ◽  
Substance Use ◽  
Chart Review ◽  
Social Issues ◽  
Admission Rate ◽  
Retrospective Chart Review ◽  
Pediatric Emergency ◽  
Problematic Substance Use ◽  
Level Of Consciousness ◽  
Problematic Substance

AbstractObjectivesGoals for this study were to characterize the substances being used by youth who presented to an emergency department (ED), their demographic descriptors, and to describe the associated acute morbidity and mortality.MethodsWe conducted a retrospective review of all youth, ages 10–16 years, who presented to a pediatric ED with complaints related to recreational drug use (n=641) for 2 years ending on December 31, 2009.ResultsThe median age of patients was 15 years; 56% were female. Six percent of patients were homeless, and 21% were wards of the state. The most frequent ingestions included ethanol (74%), marijuana (20%), ecstasy (19%), and medications (15%). Over one third of patients had ingested two or more substances. Ninety percent of patients were brought to the ED by the emergency medical services; 63% of these activations were by non-acquaintances. Of the 47% of youth who presented with a decreased level of consciousness, half had a Glasgow Coma Scale less than 13. The Canadian Triage and Acuity Scale score was 1 or 2 for 44% of patients. Sixty-eight percent received IV fluids, 42% received medication, and 4% were intubated. The admission rate was 9%.ConclusionsYouth who presented to the ED for substance use represented a socially vulnerable population whose use of recreational substances resulted in high medical acuity and significant morbidity. Improved clinical identification of such high-risk youth and subsequent design of interventions to address problematic substance use and social issues are urgently needed to complement the acute medical care that youth receive.

scholarly journals P063: Identification of emergency department patients for referral to rapid-access addiction services: A retrospective chart review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S86
Author(s):  
J. Hann ◽  
H. Wu ◽  
A. Gauri ◽  
K. Dong ◽  
N. Lam ◽  
...  
Keyword(s):  
Emergency Department ◽  
Substance Use ◽  
Chart Review ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Care Team ◽  
Addiction Medicine ◽  
Multivariable Logistic Regression Model ◽  
Factors Associated ◽  
Extract Information

Introduction: Emergency Department (ED) visits related to substance use are rapidly increasing. Despite this, few Canadian EDs have immediate access to addiction medicine specialists or on-site addiction medicine clinics. This study characterized substance-related ED presentations to an urban tertiary care ED and assessed need for an on-site rapid-access addiction clinic (RAAC). Methods: This prospective enrollment, retrospective chart review was conducted from June to August 2018. Adult patients presenting to the ED with a known or suspected substance use disorder were enrolled by any member of their ED care team using a 1-page form. Retrospective chart review of the index ED visit was conducted and the Emergency Department Information System was used to extract information related to the visit. A multivariable logistic regression model was fit to examine factors associated with recommendation for referral to a hypothetical on-site RAAC.This prospective enrollment, retrospective chart review was conducted from June to August 2018. Adult patients presenting to the ED with a known or suspected substance use disorder were enrolled by any member of their ED care team using a 1-page form. Retrospective chart review of the index ED visit was conducted and the Emergency Department Information System was used to extract information related to the visit. A multivariable logistic regression model was fit to examine factors associated with recommendation for referral to a hypothetical on-site RAAC. Results: Of the 557 enrolment forms received, 458 were included in the analysis. 64% of included patients were male and 36% were female, with a median age of 35.0 years. Polysubstance use was seen in 23% of patients, and alcohol was the most common substance indicated (60%), followed by stimulants (32%) and opioids (16%). The median ED length of stay for included patients was 483 minutes, compared to 354 minutes for all-comers discharged from the ED during the study period. 28% of patients had a previous ED visit within 7 days of the index visit, and an additional 17% had a visit in the preceding 30 days. The ED care team indicated ‘Yes’ for RAAC referral from the ED for 66% of patients, for a mean of 4.3 patients referred per day during the study period. Multivariable analysis showed that all substances (except cannabis) correlated to a statistically significant increase in likelihood for indicating ‘Yes’ for RAAC referral from the ED (alcohol, stimulants, opioids, polysubstance; p &lt; 0.05). Patients presenting to the ED with a chief complaint related to substance use were also more likely to be referred (p = 0.01). Conclusion: This retrospective chart review characterized substance-related presentations at a Canadian urban tertiary care ED. Approximately four patients per day would have been referred to an on-site RAAC had one been available. The RAAC model has been implemented in other Canadian hospitals, and collaborating with these sites to begin developing this service would be an important next step.

Psychoactive substance abuse and personality disorders in psychiatric inpatients

2011 ◽  
Vol 26 (S2) ◽  
pp. 5-5
Author(s):  
C. Almonacid ◽  
A. Castillo ◽  
M. Lloret ◽  
M. Harto ◽  
A. Tatay ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Personality Disorder ◽  
Mental Disorder ◽  
Personality Disorders ◽  
Dual Diagnosis ◽  
Specific Treatment ◽  
Psychiatric Unit ◽  
High Association ◽  
Clinical Records

IntroductionComorbidity between Substance Use Disorder (SUD) and other psychiatric disorders, known as Dual Diagnosis, is an issue of growing interest in Mental Health. The high association between Personality Disorders (PD) and substance use is reported in scientific literature. However, not many studies have been published regarding the prevalence of this disorder in a psychiatric unit. AIMSTo determine the prevalence of substance abuse among patients with a Personality Disorder in a psychiatric unit.MethodologyA retrospective descriptive study was carried out among all patients admitted to our psychiatric unit during one year. The data collected from the discharge clinical records of patients were: demographic variables, personal psychiatric history and substance use, urine tests and clinical diagnoses at discharge.ResultsWe obtained a sample of 334 patients. There was comorbidity between Mental Disorder and SUD in 10.17% of subjects; including 4% diagnosed with Personality Disorder (80% belong to Cluster B). 53.3% of patients with PD substance abuse was reported. Excluding nicotine dependence and benzodiazepines, the most common substances used were cannabis (50%), alcohol (37.5%) and cocaine (25%).ConclusionsThis study shows that Personality Disorder is the Mental Disorder most commonly associated with SUD, among inpatients in our psychiatric unit. In order to detect cases of Dual Diagnosis, we suggest optimize recording in clinical history substance use and systematic urine tests in all patients admitted, which would benefit from specific treatment for their condition.

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