Concurrent Mental Disorders Research Articles

A MICA Program: Outpatient Rehabilitation Services for Individuals with Concurrent Mental Illness and Chemical Abuse Disorders

Individuals disabled by both mental illness and chemical abuse, often referred to as dually diagnosed or disordered, provide unique and perplexing problems for treatment providers. The development of a treatment program that evolved from a traditional community based psychosocial day treatment modality to an outpatient rehabilitation program which utilizes multidisciplinary clinical approaches is discussed in detail. Staffing issues, as well as roles of the treatment team and client group members, are presented. Systems adjustments are discussed in relation to the ongoing development of a model treatment program that provides services to clients with severe psychosocial deficits, as well as substance abuse problems.

Research diagnostic criteria (RDC) mental disorder and self-reported symptoms in outpatients with complex partial seizures (CPS).

Fifteen outpatients with complex partial seizures (CPS) were investigated to assess the presence and severity of affective disorders, anxiety, and cognitive deficits. Forty percent of patients met the criteria for an affective disorder according to Research Diagnostic Criteria (RDC). Patients scored significantly higher than controls on the Beck Depression Inventory (p less than 0.001), on the State and Trait Anxiety Inventory (p less than 0.01, p less than 0.05), on the Symptom Questionnaire scales for anxiety (p less than 0.005), depression (p less than 0.01), and somatization (p less than 0.01). They also scored significantly lower than controls on the Mini-Mental State Examination for grading cognitive state (p less than 0.05). Epileptic patients with RDC diagnosis of depression reported significantly more symptoms of depression, anxiety, somatization, and less sociability and trustfulness than epileptic patients without concurrent mental disorders. Implications of these results are discussed.

Is death from natural causes still excessive in psychiatric patients? A follow-up of 1593 patients with major affective disorder.

A follow-up of 1593 Iowans with major affective disorder showed excessive mortality from unnatural causes in primary and secondary depression, and bipolar depression, but not mania, compared with age- and sex-matched controls from the general population. Excessive death from natural causes was found in women with secondary unipolar depression and bipolar depression and in manics (men and women combined) who had concurrent organic mental disorders or serious medical illnesses. Natural death was not excessive in the absence of these conditions. We conclude that excessive natural death reported in psychiatric patients is due to complicating physical disorders and not to the primary psychiatric disorder per se, whereas excessive unnatural death is due to the psychiatric disorder. Also, psychiatrically ill persons are probably referred for hospitalization more frequently when complicating physical disorders are present. Finally, we conclude that mortality patterns were similar in patients with primary and secondary unipolar depression, but bipolar patients were at lower risk for unnatural death than were unipolar patients.