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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.
Abstract: Objectifs : 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
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.

355 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.

134 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.

109 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.

84 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.

81 citations

References
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Journal ArticleDOI
TL;DR: Drugs were reportedly used to increase pleasure, to‘get high’ and to reduce depression, however, subjective effects of increased depression and positive symptoms were also reported.
Abstract: Abuse of and dependence on drugs, alcohol and other substances in schizophrenia are being increasingly recognized and well documented in the literature. It has been suggested that up to 60% of patients with schizophrenia use illicit drugs. A total of 41 subjects who fulfilled DSM-III-R criteria for schizophrenia and substance abuse or dependence were asked to describe their reasons for using such substances, the reasons why they might stop and the subjective effects of the substances. Drugs were reportedly used to increase pleasure, to 'get high' and to reduce depression. However, subjective effects of increased depression and positive symptoms were also reported. These results are considered in the context of potential treatment strategies.

173 citations


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

  • ...It is likely that the boredom, depression, and anxiety often associated with schizophrenia and often cited as reasons for use (4) would be unchanged by this treatment....

    [...]

  • ...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)....

    [...]

Journal ArticleDOI
TL;DR: The five-stages-of-change model was used to evaluate the motivational levels of 497 individuals with schizophrenia or schizoaffective disorder in an outpatient mental health clinic to suggest treatment-matching strategies in the motivation-based treatment model.
Abstract: Although the motivation to quit using substances is an important prognostic and treatment-matching factor in substance abuse treatment, there is limited information on motivation to quit among individuals with schizophrenia. This study used the five-stages-of-change model to evaluate the motivational levels of 497 individuals with schizophrenia or schizoaffective disorder in an outpatient mental health clinic. Rates of substance abuse, motivation levels to quit each specific substance, and correlates to motivational levels were evaluated. At least one substance use disorder was diagnosed in 224 of the subjects (45%); however, there was significant variability among the caseloads of the outpatient division teams. The patients in the triage/acute services and community outreach teams had substance abuse rates of about 70 percent. Most subjects had low motivation to quit substances, and the rates varied according to substance (range of 41% for opiates to 60% for cocaine). Treatment-matching strategies are suggested in the motivation-based treatment model.

160 citations

Journal ArticleDOI
TL;DR: Failure to engage patients in the experimental program posed a major and enduring barrier to treatment, despite intensive case management, and future efforts must give greater consideration to effective engagement techniques and patients' readiness for active treatment.
Abstract: Faced with many patients with comorbid severe mental illness and substance use disorders, a university-affiliated, inner-city community mental health center and a psychosocial rehabilitation center initiated this clinical trial assessing a program to care for these patients. Fifty-four patients, age

138 citations

Journal ArticleDOI
TL;DR: In this pilot study, the authors assessed 4-year outcomes for 18 schizophrenic outpatients with alcoholism who were treated in an innovative dual-diagnosis program and over half achieved stable remissions from alcoholism.
Abstract: In this pilot study, the authors assessed 4-year outcomes for 18 schizophrenic outpatients with alcoholism who were treated in an innovative dual-diagnosis program. Over half (61.1%) achieved stable remissions from alcoholism. The mean duration of remission was 26.5 months

127 citations


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

  • ...However, most studies were uncontrolled and had small samples (7-11)....

    [...]

Journal ArticleDOI
TL;DR: A once-a-week outpatient therapy group was designed for schizophrenic substance abusers and over 1 year, the group members had a marked decrease in days of hospitalization.
Abstract: A once-a-week outpatient therapy group was designed for schizophrenic substance abusers. Over 1 year, the group members (including dropouts) had a marked decrease in days of hospitalization.

95 citations

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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.