scholarly journals Dual pathology in homeless people in the Health Area of Avilés

Author(s):  
Lorena Pallas-Álvarez ◽  
Álvaro Díez-Revuelta ◽  
Juan José M. Jambrina ◽  
Martín L. Vargas

The main objective of the present study is to estimate the prevalence of severe mental and substance use disorders in homeless people (HP). The work was carried out on the basis of data obtained from a representative sample of HP in Avilés (Asturias) (n = 100) using the International Neuropsychiatric Interview (M.I.N.I.). The results of our study reveal a close relationship between substance use and homelessness. More than half of the HP have substance use disorders compared to substance use problems in the general population. Psychosocial care and the organization of a support network for the HP are discussed.

2018 ◽  
Vol 22 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Allison J Carroll ◽  
Amanda R Mathew ◽  
Frank T Leone ◽  
E Paul Wileyto ◽  
Andrew Miele ◽  
...  

Abstract Introduction Individuals with psychiatric conditions smoke at higher rates than the general population and may need more intensive treatment to quit. We examined whether or not extended treatment with nicotine patch, combined with behavior counseling, would disproportionally benefit smokers with versus without a lifetime psychiatric condition. Methods We conducted a secondary analysis of data from an effectiveness trial of treatment with 12 counseling sessions (48 weeks) and 21-mg nicotine patch (8, 24, or 52 weeks) among 525 adult daily smokers. A structured clinical interview assessed past and current psychiatric disorders (major depression, generalized anxiety disorder, alcohol abuse and/or dependence, and substance abuse and/or dependence), as described in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Abstinence was bioverified at week 52. Logistic regression evaluated the effect of the psychiatric status × treatment duration interaction on abstinence at week 52, covarying for sociodemographics, baseline psychological symptoms, and treatment adherence. Results At baseline, 115 (21.9%) participants were diagnosed with one or more psychiatric conditions. The psychiatric status × treatment duration interaction was significant for week 52 abstinence (p = .027). Abstinence rates between smokers with versus without a psychiatric condition in the 24-week treatment arm (9.3% vs. 31.5% abstinent) significantly differed from the 8-week treatment arm (18.8% vs. 22.3%), p = .017. Abstinence rates for smokers with (22.5%) versus without a psychiatric condition (19.7%) in the 52-week treatment arm did not differ from those in the 8-week arm. Conclusions Targeted smoking cessation treatment, rather than extending treatment duration, may be especially warranted to optimize treatment for smokers with comorbid mood, anxiety, and substance use disorders. Implications Individuals with psychiatric conditions smoke at higher rates and have greater difficulty quitting compared to those in the general population, but little is known about how to best optimize treatment for this high tobacco burden population. The present study found that cessation response to extended duration treatment with the transdermal nicotine patch did not differ for smokers with versus without comorbid anxiety, mood, and substance use disorders in a large-scale clinical effectiveness trial. Development of targeted behavioral treatments may be required to optimize abstinence outcomes for this high-risk population, rather than simply extending the duration of pharmacotherapy treatments.


2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Thomas Fovet ◽  
Laurent Plancke ◽  
Alina Amariei ◽  
Imane Benradia ◽  
Fanny Carton ◽  
...  

Abstract Background. The aim of the present study was to estimate prevalence rates of psychiatric and substance use disorders in male and female prisoners on admission to prison in the north of France and compare the frequency of these disorders to the general population. Methods. This cross-sectional survey on Mental Health in the Prison Population (MHPP), conducted between March 2014 and April 2017, interviewed 653 randomly selected men and women who had recently been committed to the French general population prison system in the Nord and Pas-de-Calais departments. For each subject, the Mini International Neuropsychiatric Interview (MINI), a standardized psychiatric interview, was used to screen for psychiatric and substance use disorders. The prevalence rates were then compared with data from the Mental Health in the General Population (MHGP) survey, a general population survey that used the same assessment methodology as MHPP in the Nord and Pas-de-Calais departments. A control sample was taken from the MHGP survey with a ratio of one case (MHPP) to three controls (MHGP) matching on age and sex. Results. The sample was primarily composed of French men, most of them single with low educational levels at the time of imprisonment. The mean age was 31.7 (standard deviation = 9.9; min = 18; max = 67). Most of the subjects included were first-time prisoners. The prevalence of affective disorders among newly incarcerated individuals was 31.2% with higher rates for major depressive disorder (27.2%). The prevalence of anxiety disorders was 44.4% with higher rates for generalized anxiety disorder (25.2%). The prevalence of psychotic syndromes was 6.9%. The prevalence of substance use disorders was 53.5% and a suicide risk was identified in 31.4% of the prisoners interviewed. Higher prevalence rates were found in the MHPP when compared with the MHGP for all psychiatric and substance use disorders assessed except for dysthymia and current isolated psychotic syndrome. Conclusions. Our study shows very high levels of prevalence for psychiatric and substance use disorders in recently committed French prisoners.


2016 ◽  
Vol 30 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Lauren P. Greenberg ◽  
Sarah L. Martindale ◽  
Laura R. Fils-Aimé ◽  
Sara L. Dolan

Impulsivity and distress tolerance (DT) have been implicated as key features in development and maintenance of substance use disorders. This study expanded on previous research by exploring the four factors of DT (Absorption, Appraisal, Regulation, Tolerance) and their interaction with impulsivity in relation to substance use. Participants were 105 men and 150 women who completed measures of impulsivity, DT, and substance use. Results indicated that Appraisal DT was a better predictor of substance use problems over and above overall DT or other DT factors. Mediation analysis indicated that Appraisal partially mediated the relationship between impulsivity and DT. Results suggest that DT, particularly Appraisal, plays a role in substance use problems, specifically in the relationship between impulsivity and substance use problems. Treatments emphasizing DT skills, particularly the appraisal of aversive emotions, may be useful to employ when attempting to reduce harmful drinking or drug use behaviors.


2016 ◽  
Vol 36 (3) ◽  
pp. 317-324 ◽  
Author(s):  
Katrina Prior ◽  
Katherine Mills ◽  
Joanne Ross ◽  
Maree Teesson

2000 ◽  
Vol 35 (10) ◽  
pp. 451-456 ◽  
Author(s):  
M. Teesson ◽  
T. Hodder ◽  
N. Buhrich

2019 ◽  
Author(s):  
Erik A. Levinsohn ◽  
Kevin P. Hill

Given the incredible scope of substance use disorders, this chapter will primarily focus on alcohol and opioid use disorders, while also discussing substance use broadly. Furthermore, this chapter does not provide detailed guidelines for managing patients with a substance use disorder. Instead, this review aims to provide the reader with conceptual background of the biology of addiction as well as a general framework for its diagnosis and management. While this chapter primarily focuses on physicians in the role of caregiver, it is important to note that physicians also struggle with SUDs, at a rate near that of the general population.25 This review contains 3 tables and 25 references.


2019 ◽  
Vol 11 (1) ◽  
pp. 40-43
Author(s):  
Julio Torales ◽  
João M. Castaldelli-Maia ◽  
Antonio Geraldo da Silva ◽  
Marcela W. Campos ◽  
Israel González-Urbieta ◽  
...  

Background: The management of mental disorders in child and adolescent is challenging. In addition, when substance use disorders are associated with mental disorders, important complications are noted. Dual pathology and Substance-induced disorders should be distinguished in cases like this. Objective: To summarize the latest information on the epidemiology, etiology and management aspects of dual pathology in adolescents. Methods: PubMed, Web of Science, PsycINFO and SciELO databases were searched to perform a narrative review. Results: Dual pathology is the term used to designate the co-occurrence of an addictive disorder and at least one other mental health disorder, independently. To distinguish dual pathology from substance- induced disorders, the temporal association between the disorders in a longitudinal assessment should be emphasized. If the symptoms of the mental disorder appear prior to the substance use or after a long period of abstinence, a diagnosis of dual pathology should be considered. Patients with dual pathology present greater psychosocial issues, more medical problems, and worse prognosis than those with substance-induced disorders. The proposed etiological models agree that biological, psychological and social factors are shared in the development of these conditions. Conclusion: Healthcare systems should focus on creating policies that will allow early detection, preventive public health measures, and an integrated and coordinated care for these patients. Public health policies should create means to promote awareness and prevention of these pathologies since early initiation of treatment (pharmacological, psychotherapeutic, family therapy, education in schools, behavioral interventions and treatment of comorbidities) reduces the risks associated to substance use disorders and other negative consequences.


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