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Journal ArticleDOI

Group treatment for substance abuse in schizophrenia.

01 Oct 1998-The Canadian Journal of Psychiatry (Can J Psychiatry)-Vol. 43, Iss: 8, pp 843-845

TL;DR: This pilot study describes a biweekly group specifically designed to help the individual with both schizophrenia and substance abuse, which appears to be effective for reducing substance abuse in this population.

AbstractObjectifs : Un examen de la recherche pertinente indique le besoin d'elaborer un traitement approprie, efficace et reproductible afin d 'aider les personnes aux prises avec des problemes de schizophrenie et de toxicomanie Cette etude pilote decrit un groupe dont les rencontres ont lieu deux fois la semaine et dont le but precis est de venir en aide aux personnes aux prises a la fois avec des problemes de schizophrenie et de toxicomanie Ce groupe a pour composantes le soutien, la psychopedagogie et l'acquisition de nouvelles competences On portait aussi attention a la phase du retablissement Methode : Dix-huit sujets ont frequente le groupe et ont ete evalues avant de s'y joindre Treize sujets ont accompli un suivi d'un an, et 5 ont ete evalues entre 3 et 6 mois Resultats : A l'evaluation du suivi, 8 sujets (44 %) etaient abstinents Conclusions : Ce type de traitement semble etre efficace pour la reduction de la toxicomanie chez cette population

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Citations
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Journal ArticleDOI
TL;DR: These guidelines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence.
Abstract: These guide lines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBO). The goal during the development of these guidelines was to review systematically all available evidence pertaining to the treatment of schizophrenia, and to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating people with schizophrenia. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for schizophrenia, as well as from meta-analyses, reviews and randomised clinical trials on the efficacy of pharmacological and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into four levels of evidence (A-D). This first part of the guidelines covers disease definition, classification, epidemiology and course of schizophrenia, as well as the management of the acute phase treatment. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication, other pharmacological treatment options, electroconvulsive therapy, adjunctive and novel therapeutic strategies) of adults suffering from schizophrenia.

348 citations

Journal Article
TL;DR: Individuals with psychotic disorders who show mild-to-moderate abuse of substances, in particular alcohol and cannabis, do not exhibit more cognitive impairment than those who do not do use the substances, however, substance use may have other detrimental effects on the process of the psychotic illness.
Abstract: Objective To determine the relation between substance use and cognition in individuals experiencing their first episode of psychosis.

133 citations

Journal ArticleDOI
TL;DR: This third part of the updated guidelines covers the management of the following specific treatment circumstances: comorbid depression, suicidality, variousComorbid substance use disorders (legal and illegal drugs), and pregnancy and lactation.
Abstract: These updated guidelines are based on the first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in the years 2005 and 2006. For this 2015 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations which are clinically and scientifically relevant. They are intended to be used by all physicians diagnosing and treating patients with schizophrenia. Based on the first version of these guidelines a systematic review, as well as a data extraction from national guidelines have been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and subsequently categorised into six levels of evidence (A-F) and five levels of recommendation (1-5). This third part of the updated guidelines covers the management of the following specific treatment circumstances: comorbid depression, suicidality, various comorbid substance use disorders (legal and illegal drugs), and pregnancy and lactation. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication and other pharmacological treatment options) of patients with schizophrenia.

84 citations

Book ChapterDOI
13 Jan 2011
TL;DR: The need to improve recognition of substance misuse in patients receiving palliative care, and to meet the challenges palliatives care teams face when caring for patients who have current or past opiate, benzodiazepine or alcohol addictions, emerged.
Abstract: This literature review concerned the end of life care needs of patients with drug and alcohol addiction, particularly in the UK, and to identify existing good practice guidance. Three themes emerged: » The need to improve recognition of substance misuse in patients receiving palliative care, and to meet the challenges palliative care teams face when caring for patients who have current or past opiate, benzodiazepine or alcohol addictions. » A lack of UK literature addressing the end of life care needs of patients with drug and alcohol addiction. There are articles in the US literature concerning a family-systems approach to the care of dying patients who have misused substances, and the role of social workers and counsellors in the care of dying patients receiving opiate-substitution treatment. » Inequitable access to end of life and palliative care services for homeless people, many of whom are addicted to substances or alcohol.

83 citations

Journal ArticleDOI
TL;DR: Health outcomes of the seriously mentally ill are reviewed and models designed to improve these outcomes are reviewed, and specific strategies for Family Medicine clinicians and researchers to address this problem are proposed.
Abstract: Numerous studies document disproportionate physical morbidity and premature death among people with serious mental illness. Although suicide remains an important cause of mortality for this population, cardiovascular disease is the leading cause of death. Cardiovascular death among those with serious mental illness is 2 to 3 times that of the general population. This vulnerability is commonly attributed to underlying mental illness and behavior. Some excess disease and deaths result from poor access to and use of quality health care. Negative cardiometabolic effects of newer psychotropic medications augment these trends by increasing rates of obesity, diabetes, and hyperlipidemia among those treated. Researchers have developed innovative care models aimed at minimizing the disparate health outcomes of patients with serious mental illness. Most strive to enhance access to primary care, but publications on this topic appear almost exclusively in the psychiatric literature. A focus on primary care for the prevention of excess cardiometabolic morbidity and mortality in this population is appropriate, but depends on primary care physicians' understanding of the problem, involvement in the solutions, and collaboration with psychiatrists. We review health outcomes of the seriously mentally ill and models designed to improve these outcomes. We propose specific strategies for Family Medicine clinicians and researchers to address this problem.

77 citations


References
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Journal ArticleDOI
TL;DR: Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
Abstract: The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.

16,633 citations

Journal ArticleDOI
TL;DR: In this article, the authors summarized research on self-initiated and professionally facilitated change of addictive behaviors using the key transtheoretical constructs of stages and processes of change.
Abstract: How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key transtheoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages—precontemplation, contemplation, preparation, action, and maintenance—and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a transtheoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.

7,376 citations

Journal ArticleDOI
TL;DR: The authors describe the Quality of Life Scale (QLS), a 21-item scale based on a semistructured interview designed to assess deficit symptoms and thereby fill an important gap in the range of instruments now available.
Abstract: There is growing interest in deficit symptoms in studies of the course and treatment response of schizophrenia. However, existing clinical assessment instruments focus primarily on productive symptoms. The authors describe the Quality of Life Scale (QLS), a 21-item scale based on a semistructured interview designed to assess deficit symptoms and thereby fill an important gap in the range of instruments now available. Data regarding reliability and training in the use of the QLS are presented. A factor analysis of the items yields results compatible with the conceptual model on which the scale is based. The factor analysis was also performed separately by sex and was fundamentally similar for men and women.

1,543 citations

Journal ArticleDOI
TL;DR: Results from three samples show that the Social Functioning Scale is reliable, valid, sensitive and responsive to change.
Abstract: Social functioning as an outcome variable in family interventions with schizophrenic patients has been a relatively neglected area. The requirements of a scale of social functioning to measure the efficacy of family interventions include: the measurement of skill/behaviour relevant to the impairments and the demography of this group; the ability to yield considerable information with an economy of clinical time; and the establishment of 'comparative' need through comparison between subscales and with appropriate reference groups. Results from three samples show that the Social Functioning Scale is reliable, valid, sensitive and responsive to change.

901 citations

Journal ArticleDOI
TL;DR: Schizophrenic patients who abuse drugs may represent a subgroup of patients with better prognoses and less severe clinical characteristics of schizophrenia, but their drug abuse may adversely affect global outcome.
Abstract: Objective: This study aimed to 1) determine substance abuse prevalence and preference in a diverse sample ofschizophrenic, schizoaffective, and schizophreniform inpatients, 2) cornpare drug-abusing and non-drug-abusing patients on demographic and clinical variables during the acute and stabilization phases of their hospital course, and 3) obtain data from patients on reasons for drug abuse and on acute state-related changes during periods of intoxication. Method: Eighty-three psychotic inpatients consecutively admitted to a New York City teaching hospital were evaluated. Sixty-eight had schizophrenia, 12 had schizoaffective disorder, and three had schizophreniforrn disorder diagnosed according to the Structured Clinical Interview for DSM-III-R. Each patient received ratings on the Brief Psychiatric Rating Scale, the Global Assessment Scale, and the Scale for the Assessment of Negative Symptoms at admission and at discharge, an evaluation of premorbid adjustment, and an extensive interview on drug and alcohol use. Results: Forty (48%) of the patients received diagnoses of drug or alcohol abuse or dependence. The drug-abusing patients primanly used cannabis (N=26), alcohol (N=2 1), and cocaine (N= I 4) and reported that they abused drugs to get “high, “ to relieve depression, and to relax. They had significantly fewer positive and negative symptoms at discharge, better sexual adjustment and worse school performance during adolescence, and more family histories ofdrug abuse than the non-d rugabusing patients. Conclusions: Schizophrenic patients who abuse drugs may represent a subgroup of patients with better prognoses and less severe clinical characteristics of schizophrenia, but their drug abuse may adversely affect global outcome.

572 citations


"Group treatment for substance abuse..." refers background in this paper

  • ...Reasons for use vary and include social pressure, depression, anxiety, boredom, a desire to reduce negative symptoms, a need to feel stimulated, and a need for social acceptance and interpersonal contact, for which drugs and alcohol are seen as a means (4-6)....

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Which type of facility is best for treating patient suffering with substance abuse?

This type of treatment appears to be effective for reducing substance abuse in this population.