SUD Patients Research Articles

Originalarbeiten / Original Articles. Sexuelle Risiken bei jungen Patient:innen in der stationären kinder- und jugendpsychiatrischen und -psychotherapeutischen Suchtbehandlung / Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment

Sexual Risks in Young Patients in Inpatient Child and Adolescent Psychiatric and Psychotherapeutic Addiction Treatment Engaging in fulfilling and low-risk sexual relationships is a developmental task in adolescence and young adulthood. At the same time, sexual contact is associated with risks, including early and/or unwanted pregnancies, sexually transmitted infections (STIs) and negative sexual experiences. In the present study, n = 84 inpatients in child and adolescent psychiatric and psychotherapeutic addiction treatment aged between 13 and 19 years were examined. The aim was to determine how many participants had experienced sexual risks due to (1) sexual contact under the influence of alcohol and/or drugs, (2) sexual contact without a condom outside of a committed relationship and (3) regretted sexual contact. It was also checked whether there was a state of intoxication during the situation in the three risk situations. 69.7 % of adolescent SUD patients stated that they had had sexual contact under the influence of alcohol and/or drugs. 46.1 % of SUD patients reported unprotected sexual intercourse in the last 12 months. A total of 53.6 % of female and 12.5 % of male adolescent SUD patients reported regretting sexual contact. 90 % of cases occurred while intoxicated, regardless of gender. No connection to comorbid disorders was found, but there was a clear connection to the impulsivity factor urgency. The figures indicate that young SUD patients are at considerable risk of having unwanted sexual experiences. Preventive measures should take into account aspects of managing urgency.

Study finds increases in fentanyl and stimulants from SUD patients

Study finds increases in fentanyl and stimulants from SUD patients

Personality traits as predictors of recovery among patients with substance use disorder

IntroductionSubstance use disorder (SUD) is often considered a chronic illness in which prolonged recovery, in terms of abstinence, is uncommon. Personality has been found to predict recovery, but not much is known about its long-term predictive ability as the majority of previous studies have had short follow-up periods (≥ one year). The current longitudinal cohort study therefore investigated whether personality traits predict short- (STR) as well as long-term recovery (LTR) in SUD patients. MethodsTreatment-seeking patients with SUD (n = 123) completed the NEO Personality Inventory – Revised. STR and LTR categories were defined as scoring <8 on the Alcohol Use Disorders Identification Test – C and <2 on the Drug Use Disorder Identification Test – C at the one-year and 6–8-year follow-up, respectively. Whether personality traits predicted outcome was investigated by two-tailed independent samples t-tests, α < 0.05. Additional analysis was conducted with latent growth curve model. ResultsNeuroticism (inversely, p = .004, d = 0.55) and Extraversion (p = .04, d = 0.38) predicted STR (n = 114). Although not significant the effect size for Conscientiousness was above the cut-off for a practical significant effect (d = 0.31). No traits predicted LTR category. Still, the effect sizes for LTR regarding Neuroticism (d = 0.36), Extraversion (d = 0.21) and Conscientiousness (d = 0.27) indicated that these traits have relevance for LTR. The latent growth curve model indicated that these traits predicted the short-term use of drugs and long-term use of alcohol in this cohort dominated by patients suffering from severe poly-SUD. ConclusionPersonality traits predict recovery. The effect sizes indicate that more studies with larger samples on personality traits and LTR are required to understand their possible influences on the recovery process.

Diagnosing Trauma-related Dissociative Disorders in Hungary: The Development of the Hungarian Version of MID (MID-HU)

IntroductionThe recognition, diagnostics and treatment of dissociative disorders (DD) in Hungary is currently in its infancy. According to international researches the prevalence of dissociative disorders is similar to that of the major psychiatric disorders (bipolar disorder, schizophrenia, etc.). Due to the lack of valid diagnostic tools no data is available regarding the prevalence of dissociative disorders in Hungary so far.ObjectivesTo fill this gap within our profession; to provide a complex diagnostic tool; developing the hungarian version of the Multidimensional Dissociation Questionnaire (MID-HU)Methods 341 people participated in our study classified into four groups: (1) healthy controls (n=88), (2) patients from private practice diagnosed with DD and all those participants who have DD according to their MID results (n=103), (3) hospitalized psychiatric (mixed sample, n=60) and (4) SUD patients (n=89). The questionnaire package contained the hungarian version of the Multidimensional Inventory of Dissociation (MID-HU), the Dissociative Experience Scale (DES), the Traumatic Antecendents Questionnaire (TAQ), the Self-Report Version of the Dissociative Disorders Interview Schedule (DDIS-SR) and additional questions. Now we present the first results regarding the adaptation process of the hungarian MID (MID-HU).ResultsThe mean age of the participants was 36 years, 61,6% were female and 38,4% male. The MID-HU has strong internal consistency: the alpha coefficients for the 14 facet scales were 0.88 or higher. The alpha coefficients for the 23 dissociation diagnostic scales ranged from 0,74-0,95; 9 were excellent (0,90 or above), 10 were good (0,80 or above), and 4 were fair (0,70 or above). The test-retest correlation of the Mean MID-HU scores is good (0,87). Factor analysis of the MID-HU extracted one main factor: dissociation. The mean MID-HU scores correlated with mean DES scores (0,87), indicating a good convergent validity. We found significant differences between the healthy control group and the dissociatve group in the mean DES (control: 9,5, dissociative: 27,6, Sig:&lt;0,001), mean MID (control: 2,5, dissociative: 27, Sig: &lt;0,001), the 23 dissociative diagnostics scales of the MID, 14 facet scales of the MID, and all diagnostics scales of the DDIS (using Mann-Whitney).ConclusionsThe MID-HU seems to be a valid instrument, that can differentiate between DD patients and healthy people.Disclosure of InterestNone Declared

Sex- and Gender-Specific Drug Abuse Dynamics: The Need for Tailored Therapeutic Approaches.

Sex and gender have been gaining ever greater attention due to their associated risks, dynamics, patterns and protective factors underlying substance abuse and addiction. Such differentiations and the clarification of complexities thereof take on even greater relevance in light of drug abuse scope worldwide. According to the 2022 World Drug Report released by the United Nations Office on Drugs and Crime (UNODC), in 2020 an estimated 284 million people worldwide aged 15-64 had used a drug within the last 12 months. The authors have set out to shed a light on determinants and contributing factors of drug abuse based on sex and gender and outline policy and medicolegal remarks aimed at delineating sex- and gender-based approaches towards drug abuse therapeutic interventions that are both therapeutically and ethically/legally viable and grounded in an evidence-based set of standards. Neurobiological data suggest that estrogen may facilitate drug taking by interacting with reward- and stress-related systems. In animal research, the administration of estrogen increases drug taking and facilitates the acquisition, escalation, and reinstatement of cocaine-seeking behavior. From a medicolegal perspective, it is of utmost importance to take into account the whole picture constituting each patient profile, which certainly includes gender factors and contributors, when outlining a therapeutic approach. Failure to do so could lead to negligence-based malpractice allegations, in light of the scientific findings representing best practices with which clinicians need to comply when caring for SUD patients.

Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment

IntroductionSubstance use disorders(SUDs) are a major health concern and current treatment interventions have proven only limited success. Despite increasing effectiveness, still about 50–60% relapse within 6–12 months after treatment [Cornelius et al., Addict Behav. 2003;28 381-386]. SUDs are defined as chronic disorders of brain reward system, motivation, and memory processes that have gone awry. Medication reducing craving and substance use is mainly available for alcohol dependence and to a lesser extent for other substances.Hallucinogens may represent a group of agents with potential anti-craving properties subsequently reducing substance use in SUD patients. For instance, lysergic acid diethylamide(LSD) and psilocybin have previously been shown to effectively alleviate symptoms of alcohol and nicotine dependence.ObjectivesNew treatments preferably focusing on reducing craving and subsequent substance use are therefore urgently needed. The hallucinogen psilocybin may provide a new treatment option for SUD patients, given the beneficial results observed in recent studiesMethodsSystematic revision of literature.ResultsIn the 1950s, a group of drugs with potential to alter consciousness were discovered (hallucinogens). Several studies suggested their anti-SUD potential, improving self-acceptance and interpersonal relationships, reducing craving and alcohol use. As a result of its recreational popularity during the 1960s, they were banned in 1967, greatly hampering scientific research in this field. Recently, psilocybin, an hallucinogenic substance in psilocybin-containing mushrooms has gained popularity in neuropsychological research, showing to increase trait openness, cognitive and behavioral flexibility, and ratings of positive attitude, mood, social effects, and behavior and even reported persistent positive changes in attitude and behavior. These findings might suggest a valuable compound for the treatment of psychiatric conditions with several additional studies providing supportive evidence for the therapeutic potential of psilocybin for SUD treatment and relapse prevention.ConclusionsWith the reported limited amount of side effects and potential beneficial effects of psilocybin in SUD, there are valid reasons to further investigate the therapeutic efficacy and safety of psilocybin as a potential SUD treatment. On the one hand, psilocybin may exert its anti-addictive properties by beneficial effects on negative emotional states and stress. On the other hand, psilocybin may improve cognitive inflexibility and compulsivity. Research on the efficacy of psilocybin on SUD is still limited to a handful of published studies to date. As a result, many important questions related to the use of psilocybin as a complement to current treatment of SUD and its working mechanisms remain unanswered. Before psilocybin can be implemented as a treatment option for SUD, more extensive research is needed.Disclosure of InterestNone Declared

Individual factors predict substance use treatment course patterns among patients in community-based substance use disorder treatment.

Substance use disorders (SUDs) usually involve a complex natural trajectory of recovery alternating with symptom reoccurrence. This study examined treatment course patterns over time in a community SUD clinic. We examined depressive symptoms level, primary SUD assigned at each admission, and lifetime misuse of multiple substances as potential risk factors for premature treatment termination and subsequent treatment readmission. De-identified longitudinal data were extracted from charts of 542 patients from an SUD treatment center. Survival analysis methods were applied to predict two time-to-event outcomes: premature treatment termination and treatment readmission. Primary opioid (vs alcohol) use disorder diagnosis at admission was associated with higher hazard of premature termination (HR = 1.91, p<0.001). The interaction between depressive symptoms level and substance use status (multiple vs single use) on treatment readmission was significant (p = 0.024), such that higher depressive symptoms level was predictive of readmission only among those with a history of single substance use (marginally significant effect). Lifetime use of multiple (vs single) substances (HR = 1.55, p = 0.002) and age (HR = 1.01, p = 0.019) predicted increased hazard of readmission. Findings did not support a universal role for depressive symptoms level in treatment course patterns. Primary SUD diagnosis, age, and history of substance misuse can be easily assessed and incorporated into treatment planning to support SUD patients and families. This study is the first to our knowledge that afforded a stringent test of these relationships and their interactions in a time-dependent, recurrent event, competing risks survival analysis examining both termination and readmission patterns utilizing a real-world clinic-based sample.

The clinical course of comorbid substance use disorder and attention deficit/hyperactivity disorder: protocol and clinical characteristics of the INCAS study

BackgroundSubstance use disorders (SUD) often co-occur with attention deficit hyperactivity disorder (ADHD). Although the short-term effects of some specific interventions have been investigated in randomized clinical trials, little is known about the long-term clinical course of treatment-seeking SUD patients with comorbid ADHD.AimsThis paper presents the protocol and baseline clinical characteristics of the International Naturalistic Cohort Study of ADHD and SUD (INCAS) designed and conducted by the International Collaboration on ADHD and Substance Abuse (ICASA) foundation. The overall aim of INCAS is to investigate the treatment modalities provided to treatment-seeking SUD patients with comorbid ADHD, and to describe the clinical course and identify predictors for treatment outcomes.This ongoing study employs a multicentre observational prospective cohort design. Treatment-seeking adult SUD patients with comorbid ADHD are recruited, at 12 study sites in nine different countries. During the follow-up period of nine months, data is collected through patient files, interviews, and self-rating scales, targeting a broad range of cognitive and clinical symptom domains, at baseline, four weeks, three months and nine months.ResultsA clinically representative sample of 578 patients (137 females, 441 males) was enrolled during the recruitment period (June 2017-May 2021). At baseline, the sample had a mean age (SD) of 36.7 years (11.0); 47.5% were inpatients and 52.5% outpatients; The most prevalent SUDs were with alcohol 54.2%, stimulants 43.6%, cannabis 33.1%, and opioids 14.5%. Patients reported previous treatments for SUD in 71.1% and for ADHD in 56.9%. Other comorbid mental disorders were present in 61.4% of the sample: major depression 31.5%, post-traumatic stress disorder 12.1%, borderline personality disorder 10.2%.ConclusionsThe first baseline results of this international cohort study speak to its feasibility. Data show that many SUD patients with comorbid ADHD had never received treatment for their ADHD prior to enrolment in the study. Future reports on this study will identify the course and potential predictors for successful pharmaceutical and psychological treatment outcomes.Trial registrationISRCTN15998989 20/12/2019.

Prevalence and hospital resource usage associated with substance use disorder among hospitalized adolescents in the United States

We sought to determine common characteristics of SUD-related hospitalizations and patterns of discharge diagnoses among adolescents in the United States. Using the 2016 KID, a cross-sectional study was conducted to identify discharge records associated with ICD-10-CM diagnostic codes for SUD. Adolescents between the ages of 13 and 19 were included. SUD and non-SUD groups were compared using the Student’s t-test for continuous variables and the χ2 test for categorical variables. A total of 6.7 million hospital discharges were analyzed. A uniform and a standardized coding system were used to identify cases. Subgroup comparative analysis for length of stay, hospital charge, and common discharge diagnoses was performed. A weighted estimate of 94,732 adolescents associated with SUD was discharged from the U.S. hospitals during the study year. Teens with SUD accounted for 510,268 days of inpatient days in the U.S. community hospitals accounting for a total charge of $3,070,948,580. The average LOS for all SUD teens in the U.S. was 5.4 days with a mean charge per discharge of $32,754, indicating higher LOS but a significantly lower mean charge compared to non-SUD teens (4.1 days; $39,657). In 2016, more than 88% of SUD patients had ≥ 3 diagnoses compared to non-SUD patients (76%) (P < 0.0001 for all). The most frequently observed diagnosis associated with teens with SUD was psychoses, depressive neuroses, and alcohol use disorder. With one in ten teenagers found with an SUD, early substance initiation still appears to be an important public health issue. Unfortunately, the health and economic impact of substance use in adolescence on society are huge requiring effective strategies targeted to this population. The concerning data and literature identify a significant need to address prevention, treatment, and recovery services for adolescents throughout the United States.

Substance Use Disorders: Suicide and Self-Harm

Aims: To specify the demographic and risk factors and type of the substance use disorders most common with suicidal behaviors and self-harm.&#x0D; Study Design: Observational cross-sectional research.&#x0D; Place and Duration of Study: Neuropsychiatry Department and Psychiatry, Neurology and neurosurgery center, Tanta University, Tanta, Egypt. The study was conducted for duration of 6 months from January 2019 to June 2019.&#x0D; Methodology: This was enrolled 105 aged 18-50 years to assess the type of substance use disorders most common with suicidal behaviours and self-harm with any duration of illness. Subjects were divided into three equal groups: Group 1 included healthy control subjects with no addiction or psychiatric problems with no history suggestive of any health problems. Group 2 included patients with substance use disorders (addict group). Group 3 included psychiatric patients without substance use disorders. All patients were subjected to addiction severity index, Beck Depression Inventory-II, Hamilton Anxiety Rating Scale, Suicide probability scale, Barratt's impulsiveness scale, Self-Harm diagnosis scale and the positive and negative syndrome scale.&#x0D; Results: There was a significantly different in the suicide categories among the cases with and without heroin intake (p=0.038). There was a significantly positive correlation among addiction severity index (ASI) and suicide score in the addiction group.&#x0D; Conclusion: The incidence of anxiety and depression among individuals with substance use disorders is notably high, particularly at severe levels. We found also positive correlations between ASI and both suicide and self-harm scores in the addiction group. Depression and anxiety are frequently co-occurring in SUD patients.

Differences in alcohol and cannabis use amongst substance use disorder patients with and without comorbid attention-deficit/hyperactivity disorder.

BackgroundSubstance use disorders (SUDs) continue to be a public health problem. Attention-deficit/hyperactivity disorder (ADHD) is seen as a risk factor for SUD. Prevalence of alcohol and cannabis use amongst adults with SUD and comorbid ADHD impacts both disorders cognitively and behaviourally.AimOur study aimed to compare alcohol and cannabis use between treatment-seeking SUD patients with ADHD and SUD patients without ADHD symptomatology.SettingVarious rehabilitation centres, including the South African National Council on Alcoholism and Drug Dependence (SANCA) Centres, and Private and Provincial Government Substance Abuse Treatment Centres.MethodsA cross-sectional study of adults on drug rehabilitation was conducted. Data on socio-demographic information and alcohol and cannabis use from 185 post-detox inpatients were collected. Diagnoses were based on DSM-IV criteria. Attention-deficit/hyperactivity disorder diagnosis was confirmed by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). SUD+ADHD (n = 52) and SUD-ADHD (n = 128) groups were compared on alcohol and cannabis use as a function of gender.ResultsNo significant differences in the use of alcohol between the SUD+ADHD and SUD-ADHD groups were found. However, the SUD+ADHD group showed increased cannabis consumption. Especially, the SUD+ADHD females showed an earlier age of onset of cannabis use than the SUD-ADHD females and revealed that they use cannabis for a longer period compared with the SUD-ADHD females and SUD+ADHD and SUD-ADHD males.ConclusionThe results revealed the relationship between ADHD and cannabis use, especially amongst females with ADHD and reinforce the need to consider ADHD in cannabis use SUD in clinical interventions.

Exercise capacity, lung and respiratory muscle function in substance use disorders

BackgroundSubstance use disorder (SUD) causes conditions such as cognitive and behavioral disorders, anxiety, depression, and social isolation it also causes acute airway inflammation by affecting airway bronchial dynamics. The current study aimed to investigate the lung function, respiratory muscle strength, and exercise capacity in patients with SUD. MethodsOne hundred-eighty three patients with SUD, a total of 119 healthy controls, 54 of whom were cigarette smokers and 65 of whom were non-smokers were included in the study. Spirometric tests, respiratory muscle strength (MIP and MEP), and the 6-Minute Walk Test (6-MWT) were assessed. The III National Health and Nutrition Examination Survey were used to evaluate respiratory symptoms in patients with SUD and cigarette smokers. Results86.3% of the SUD patients included in the study were using heroin, 9.2% were cannabis, and 5.5% were spice. The most common symptom in both SUD patients and cigarette smokers was shortness of breath, wheezing, and sputum production. After post-hoc tests, the FVC (p = 0.002), FVC (%predicted) (p < 0.0001), FEV1 (p = 0.002), FEV1 (%predicted) (p < 0.0001), FEV1/FVC (%) (p < 0.0001), PEF (p < 0.0001) and FEF%25-75 (p < 0.0001) lung function parameters were significantly lower in SUD patients than non-smokers. In addition, it was found that MIP (p < 0.0001), MIP (%predicted) (p < 0.0001), MEP (p < 0.0001), and MEP (%predicted) (p < 0.0001) values of SUD patients were significantly lower than non-smokers. ConclusionThe study findings indicate that substance use has an effect on lung functions and the most commonly reported symptoms are shortness of breath, wheezing, and sputum production. In addition, respiratory muscle strength and exercise capacity were decreased in SUD patients compared to non-smokers.

Investigating defensive functioning and alexithymia in substance use disorder patients

BackgroundSubstance Use Disorder (SUD) causes a great deal of personal suffering for patients. Recent evidence highlights how defenses and emotion regulation may play a crucial part in the onset and development of this disorder.The aim of this study was to investigate potential differences in the defensive functioning between SUD patients and non-clinical controls. Secondly, we aimed at investigating the relationships between alexithymia and maladaptive/assimilation defenses.MethodsThe authors assessed defensive functioning (Response Evaluation Measure-71, REM-71), personality (MMPI-II), and alexithymia (TAS-20) of 171 SUD patients (17% female; mean age = 36.5), compared to 155 controls. Authors performed a series of ANOVAs to investigate the defensive array in SUD patients compared to that of non-clinical controls. Student t test for indipendent samples was used to compare clinical characteristics between the SUD group and the controls. To investigate the role of single defenses in explaining alexithimia’s subscores, stepwise multiple regression analysis were carried out on socio-demographic characteristics of participants (gender, age, and years of education), with REM-71 defenses as predictors.ResultsSUD patients presented a more maladaptive/assimilation (Factor 1) defensive array (p < .001). Among SUD sub-groups, Alcohol Use Disorder patients showed more disfuncional defenses. Factor 1 defenses were related to a worse psychological functioning. In addition, alexyhimia (particularly DIF) was strongly related to Factor 1 defenses, expecially Projection (38% of variance explained, β = .270, p < .001).ConclusionThe REM-71 and the TAS-20 might be useful screening instruments among SUD patients.

The relationship between posttraumatic stress symptoms and craving in patients with substance use disorder attending detoxification

BackgroundSubstance use disorder (SUD) and posttraumatic stress disorder (PTSD) are highly comorbid. Self-medication hypothesis (SMH) is a seminal theory aiming to account for the relationship between these disorders. The current study examined hypotheses based on SMH in SUD patients during the very first days of detoxification. Based on SMH we expected a positive association between PTSD and craving concurrently as well as on each following day. MethodsA time series with 108 SUD patients used daily self-report questionnaires assessing PTSD symptom severity (PCL-5) and craving (MaCs) for six consecutive days. Daily associations between PTSD symptom severity and craving on the same and on the following day during the first week of detoxification were estimated using linear mixed models. ResultsThere was a significant decrease in PTSD symptom severity during detoxification (ß = -2.06, p < 0.001). Further, PTSD symptom severity predicted craving on the same day (ß = 0.36, p < 0.001) but did not predict craving on the next day (ß = -0.01, p = 0.82). ConclusionResults of the current study only partially support assumptions based on SMH, and points towards a more complex and reciprocal relationship between PTSD and SUD.

SUD Patients More Susceptible to COVID-19, Adverse Outcomes

SUD Patients More Susceptible to COVID-19, Adverse Outcomes

Experiences of playing golf as a part of the treatment and rehabilitation process among patients in substance use disorder treatment

ABSTRACT Background The Norwegian organization Golf as Therapy (GAT) offers golf training sessions for patients in mental health care and/or SUD treatment. Our aim for the article was to explore SUD patients’ experiences of playing golf during their treatment. Method We conducted semistructured interviews with seven informants, all of whom were SUD patients or former SUD patients of the Tyrili Foundation. Results A thematic analysis led us to identify three themes. 1) The participants had negative stereotypical perceptions of golf and golf players. When they entered the golf course, these perceptions were largely refuted. 2) The participants enjoyed the versatility that golf demanded but highlighted the social interaction that occurred at the golf course as the most valuable and motivating part of their enjoyment of golf. 3) The participants had positive experiences playing golf that they saw as valuable for developing social networks and for becoming more open-minded about trying new activities. Conclusions Golf seems to potentially stimulate social participation and to develop relations, and it was perceived as useful for the informants’ situations both during and after treatment. This may strengthening the patients’ social identity and social capital. Therefore, golf as an activity could be benefiting for patients in SUD-treatment.

The Effects of Prolonged Exposure on Substance Use in Patients With Posttraumatic Stress Disorder and Substance Use Disorders.

Despite research demonstrating the benefit of exposure-based therapy for posttraumatic stress disorder (PTSD) in patients with co-occurring substance use disorders, there remains a strong clinical expectation that this treatment will exacerbate substance use or other psychiatric symptoms. The present study evaluated within-session and session-to-session changes in (a) craving and use of substances for a range of drug classes and (b) symptoms of PTSD and other psychiatric distress in a sample of 44 SUD patients who received prolonged exposure (PE) therapy for PTSD. Visual analog scales showed no within-session increases in craving, except for cocaine, within Session 8. Across sessions, craving scores dropped for heroin, methadone, benzodiazepines, and cocaine; no increases in craving were found. Past-week substance use reported at each session did not differ. The severity of PTSD symptoms and self-reported serious emotional problems decreased from Session 1 to subsequent sessions, with no increases or decreases in other psychiatric, social, or medical problems. Finally, PTSD severity was unrelated to substance use reported 1 or 2 weeks later. Substance use during the past week was associated with higher PTSD severity scores at the next session, B = 6.86 (SE = 2.87), p = .018, but was not associated 2 weeks later. These findings indicate that the concern that exposure therapy for PTSD will increase SUD patients' substance use or other psychiatric symptoms may be unwarranted, and, thus, SUD patients, including those who are actively using, should have access to effective treatments for PTSD, like PE.

Study of attention measured by event-related potential as a predictive factor of violence among patients with schizophrenia and substance use disorder

BackgroundThe prediction of violence in patients with psychiatric disorders remains a challenging aspect in the field of clinical research. Many studies search the linkage between aggressive behavior and certain genetic conditions, impaired socio-emotional information processing, demographic, and clinical variables. To our knowledge, by far the relationship between aggressive behavior and impaired attention is not clear. Attention is one of the clinical variables that might have a relation to increased aggressive tendency in many psychiatric patients. So the purpose of this study is to measure the attention using ERP and search for its relation to violence in schizophrenic patients and patients with substance use disorder. This cross-sectional study was carried out on a sample of schizophrenic inpatients and patients with SUD (86 male patients) at the psychiatric department of Al-Hussein University Hospital, Cairo, Egypt.ResultsThe majority of the sample lies in the age group 20–29 years old (38.4%), whereas MOAS showed that the higher tendency to violence was in the dual diagnosis of schizophrenia disorder with SUD followed by patients diagnosed with SUD.P300 wave measurement analysis reflected that the attention is highly affected in SUD patients, while schizophrenics showed delayed thinking. The relationship has a statistical significance (P = 0.001).A statistically significant direct correlation between P300 wave amplitude, latency, and the scale of violence was also found (P = 0.009 and P = 0.022) respectively.ConclusionAffected attention in both schizophrenic and SUD patients could be considered a potential risk factor of violence.

Improving Outcomes of Care for HRSA-Funded Health Center Patients Who Have Mental Health Conditions and Substance Use Disorders.

The rising prevalence of mental health conditions and substance use disorders (MH/SUD) underscores the important role of health centers (HCs) in caring for low-income and uninsured MH/SUD patients. This study used the 2014 Health Center Patient Survey and 2014 Uniform Data System to determine the independent association between delivery of MH/SUD integration and related interventions to patients that reported a MH/SUD condition (n=2714) with the number of HC visits, emergency department (ED) visits, and hospitalizations last year. Results showed that health education was associated with fewer predicted ED visits (1.8 vs. 2.3) and lower likelihood of hospitalizations (16% vs. 24%) among MH patients. Medical enabling services was associated with lower rates of ED visits (0.3 vs.1.9) and hospitalizations (< 1% vs. 13%) among SUD patients. The results indicate the utility of integration and related intervention services in primary care settings to improve service use and reduce ED and hospitalization among MH/SUD patients.

Effect of Training Program on the Nurses’ Attitude and Perception of Caring Behavior toward Substance Use Disorder Patients

Nurses are responsible for the holistic care of substance use disorder patients, which encompasses the psychosocial, developmental, cultural, and spiritual needs of the individual, and helped to manage physical needs, prevent illness, and treat health conditions, they consider the vital caregiver for SUD patients. To do this important role, they need to have good knowledge, positive attitude and caring behavior skills toward these patients. Aim of the study: This study was aimed to determine the effect of training program on the nurses’ attitude and perception of caring behavior toward substance use disorder patients. Subjects of study: Sample consisted of 50 nurses who were chosen by convenient sampling. A quasi-experimental design was utilized. Tools of the study: Two tools were used for data collection; Substance Abuse Attitudes Survey (SAAS) designed to measure nurses' attitudes towards substance use disorder and Caring Behavior Assessment Tool (CBA) aims to assess nurse' perception regarding caring behavior toward substance use disorder patients. Result of the study: The results revealed that there was statistically significant improvement in nurses’ attitude and perception of caring behavior skill regarding substance use disorder patients before and after implementing of the training program. Conclusion , recommendation: The study concluded that training program about substance use disorder enhancing the nurses’ attitude and perception of caring behavior skills toward substance use disorder patients .According to these results, the study recommended that hospital policies must encourage nurses to attend in-service training program about attitude and caring behavior skills toward substance use disorder patients.