Coping Strategies in Male Patients under Treatment for Substance Use Disorders and/or Severe Mental Illness: Influence in Clinical Course at One-Year Follow-Up.

Julia Marquez-Arrico,José Navarro,Laura Río-Martínez,Gemma Prat,Diego Forero,Ana Adan

doi:10.3390/jcm8111972

Abstract

Coping strategies have an impact on substance use disorders (SUD), relapses, and clinical variables, but knowledge on this area is scarce. We explored the coping strategies used during treatment in patients with dual diagnosis (DD), SUD, and severe mental illness (SMI), and the relation with clinical course and relapses at one-year follow-up. A sample of 223 patients was divided into three groups depending on diagnosis: DD (N = 80; SUD with comorbid schizophrenia or major depressive disorder), SUD only (N = 80), and SMI only (N = 63; schizophrenia or major depressive disorder). MANCOVA analyses reflected differences in self-criticism and problem avoidance, with a higher use of these in the DD and SUD groups. The coping strategies used differed depending on the presence/absence of a SUD, but not depending on psychiatric diagnosis. At one-year follow-up, social support was the only strategy that predicted the presence of relapses in DD patients with schizophrenia (positively), and in SMI patients with major depressive disorder (negatively). Thus, social support was associated with relapses, but the relationship was different depending on psychiatric diagnosis. Further studies should analyze the implications of social support as a coping strategy in different mental disorders, as well as its usefulness in individualized interventions.

Highlights

During recent years, scientific interest in how people cope with stress and adversity has increased significantly, since coping strategies are known to have an influence on the differences observed among people under stress, and have proven their importance as a stabilizing factor, facilitating individual adjustment and leading to better health [1,2,3].Coping strategies are understood as specific actions that individuals use in order to manage, change, and/or reduce the consequences of exposition to stressors [4,5]
Our inclusion criteria were: (1) Male gender; (2) aged 19 to 55 years; (3) currently under treatment for their mental disorders, but in a clinically stable condition; (4) the diagnoses of major depressive disorder or schizophrenia in the dual diagnosis (DD) and severe mental illness (SMI) groups had been established according to DSM-5 criteria [42]; (5) a current diagnosis of substance use disorders (SUD) for the DD and SUD patients, including those with addiction in early remission according to DSM-5 criteria [42]
Our study focused on the coping strategies used by patients with DD, SUD, and SMI, comparing the strategies used by each group in reference to the Spanish normative data

Summary

Introduction

Scientific interest in how people cope with stress and adversity has increased significantly, since coping strategies are known to have an influence on the differences observed among people under stress, and have proven their importance as a stabilizing factor, facilitating individual adjustment and leading to better health [1,2,3].Coping strategies are understood as specific actions that individuals use in order to manage, change, and/or reduce the consequences of exposition to stressors [4,5]. Among people who use drugs, a very high percentage use the substance itself as self-medication to confront daily stressful situations [10] This avoidance coping pattern is a strategy positively associated with drug use [11,12], whereas engaging in adaptive coping is related to a decrease in substance abuse, improving SUD treatment effects [11]. In this sense, the use of dysfunctional strategies in patients with SUD has been linked to the severity of their addiction [13,14] and the frequency of relapses [13,15]

Methods

Results

Discussion

Conclusion