Psychiatric severity and mortality in substance abusers: a 15-year follow-up of drug users.
TL;DR: Psychiatric treatment, including psychotherapy, may be more life-saving for substance abusers than drug-abuse services because it is predictive of 15-year mortality, whereas abstinence was not.
About: This article is published in Addictive Behaviors.The article was published on 2006-04-01. It has received 45 citations till now. The article focuses on the topics: Abstinence & Symptom Checklist 90.
Citations
More filters
TL;DR: Mortality among opioid-dependent users varies across countries and populations; treatment is clearly protective against mortality even in non-randomized observational studies; study characteristics predict mortality levels.
Abstract: Aims To review the literature on mortality among dependent or regular users of opioids across regions, according to specific causes, and related to a number of demographic and clinical variables. Methods Multiple search strategies included searches of Medline, EMBASE and PsycINFO, consistent with the methodology recommended by the Meta‐analysis of Observational Studies in Epidemiology (MOOSE) group; grey literature searches; and contact of experts for any additional unpublished data from studies meeting inclusion criteria. Random‐effects meta‐analyses were conducted for crude mortality rates (CMRs) and standardized mortality ratios (SMRs), with stratified analyses where possible. Meta‐regressions examined potentially important sources of heterogeneity across studies. Results Fifty‐eight prospective studies reported mortality rates from opioid‐dependent samples. Very high heterogeneity across studies was observed; pooled all‐cause CMR was 2.09 per 100 person‐years (PY; 95% CI; 1.93, 2.26), and the pooled SMR was 14.66 (95% CI: 12.82, 16.50). Males had higher CMRs and lower SMRs than females. Out‐of‐treatment periods had higher mortality risk than in‐treatment periods (pooled RR 2.38 (CI: 1.79, 3.17)). Causes of death varied across studies, but overdose was the most common cause. Multivariable regressions found the following predictors of mortality rates: country of origin; the proportion of sample injecting; the extent to which populations were recruited from an entire country (versus subnational); and year of publication. Conclusions Mortality among opioid‐dependent users varies across countries and populations. Treatment is clearly protective against mortality even in non‐randomized observational studies. Study characteristics predict mortality levels; these should be taken into account in future studies.
726 citations
TL;DR: Given the widespread use of amphetamines, the known non-fatal adverse effects of use and the mortality rates reported here, cohort studies investigating the morbidity and mortality associated with such drug use should be a research priority.
95 citations
TL;DR: For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development).
Abstract: The present study had three main objectives: (1) to develop and validate scales of young adult social competence in two domains, close relationships and social groups, using peer ratings of California Q-sort (Block, 1974; Kremen & Block, 2002) items; (2) to test the hypothesis that social competence is associated with young adult well-being and ego development; (3) to test the hypothesis that close relationship competence aligns more closely than social group competence with young adult functioning. Psychometric data on peer ratings of social competence are presented. For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development). Associations were generally stronger for competence in close relationships than in social groups.
62 citations
Cites methods from "Psychiatric severity and mortality ..."
...The SCL-90 includes nine primary symptom dimensions and three global indices, and has been used extensively in the literature (e.g., Fridell & Hesse, 2006; Wijnberg-Williams, Kamps, Klip, & Hoekstra-Weebers, 2006)....
[...]
TL;DR: Results show that the treatment of dually diagnosed patients with severe problems needs to include both the foci because it leads to enormous gains for the patients when personality disorders are also addressed.
Abstract: Purpose of review The present review examines the outcomes of treatments focusing on substance abuse, on personality disorders, and on both the foci simultaneously. Clinical guidelines for the treatment of dually diagnosed patients are described. Recent findings Recent studies continued the tradition of examining the importance of factors such as the chronicity of substance abuse and the impact of sex with regard to the prognosis of the treatment of substance abuse and the development of effective treatment programs. Overall, the multifaceted and risky nature of dual problems is stressed, and as a logical consequence, an early detection of dual problems is promoted. Several studies show the risk of suicidal and harmful behavior associated with this population, even when the treatment for substance abuse has been successful. For the first time, the issue of dropout is studied from the client's perspective. Summary Knowledge about the effectiveness of dually focused treatments is emerging. Results show that the treatment of dually diagnosed patients with severe problems needs to include both the foci because it leads to enormous gains for the patients when personality disorders are also addressed. Yet, integrated treatment programs are lacking and research is still too limited.
61 citations
TL;DR: This study confirms the high mortality of heroin addicts even after enrollment in methadone maintenance treatment (MMT), and women who survived the 25-year follow-up were more likely to have stopped using heroin than men.
58 citations
Cites background from "Psychiatric severity and mortality ..."
...The excess mortality over the life-span of drug abusers is of interest, because it implies the need for services over the life course, over and above the need for treatment services that show effectiveness in the short term (Fridell & Hesse, 2006)....
[...]
...The few existing data suggest a higher mortality rate among men (Bauer et al., 2008; Coffin et al., 2003; Fridell & Hesse, 2006; Hickman et al., 2003)....
[...]
References
More filters
Journal Article•
3,761 citations
TL;DR: The Structured Clinical Interview for DSM-HI-R Personality Disorders (SCID-II) as mentioned in this paper is a clinician-administered semistructured interview for diagnosing the 11 Axis II personality disorders of the Diagnostic and Statistical Menual of Mental Disorders (3rd ed., rev.), plus the Appendix category selfdefeating personality disorder.
Abstract: The history and description of the Structured Clinical Interview for DSM-HI-R Personality Disorders (SCID-II) is presented. The SCID-II is a clinician-administered semistructured interview for diagnosing the 11 Axis II personality disorders of the Diagnostic and Statistical Menual of Mental Disorders (3rd ed., rev.), plus the Appendix category self-defeating personality disorder. The SCID-II is unique in that it was designed with the primary goal of providing a rapid clinical assessment of personality disorders without sacrificing reliability or validity. It can be used in conjunction with a self-report personality questionnaire, which allows the interview to focus only on the items corresponding to positively endorsed questions on the questionnaire, thus shortening the administration time of the interview.
734 citations
TL;DR: The authors conducted TLFB interviews with a sample of adult drug-abusing patients seeking treatment for substance abuse and found that the patients' reports about their drug consumption using this method generally had high retest reliability, convergence and discriminant validity with other measures, and agreement with collateral informants' reports of patients' substance use.
Abstract: The Timeline Followback (TLFB; L. C. Sobell & M. B. Sobell, 1996) interview, which uses a calendar method developed to evaluate daily patterns and frequency of drinking behavior over a specified time period, has well-established reliability and validity for assessing alcohol consumption. Although several investigators have used the TLFB to evaluate drug-using behavior, few studies have examined the psychometric properties of the interview for this purpose. The authors conducted TLFB interviews with a sample of adult drug-abusing patients seeking treatment for substance abuse (n = 113) at baseline, posttreatment, and quarterly thereafter for 12 months. It was found that the patients' reports about their drug consumption using this method generally had high (a) retest reliability, (b) convergent and discriminant validity with other measures, (c) agreement with collateral informants' reports of patients' substance use, and (d) agreement with results from patients' urine assays.
560 citations
TL;DR: Underpowered studies persist in the psychological literature and the effects on efforts to create a cumulative science are examined and the "curse of multiplicities" plays a central role.
Abstract: Underpowered studies persist in the psychological literature. This article examines reasons for their persistence and the effects on efforts to create a cumulative science. The "curse of multiplicities" plays a central role in the presentation. Most psychologists realize that testing multiple hypotheses in a single study affects the Type I error rate, but corresponding implications for power have largely been ignored. The presence of multiple hypothesis tests leads to 3 different conceptualizations of power. Implications of these 3 conceptualizations are discussed from the perspective of the individual researcher and from the perspective of developing a coherent literature. Supplementing significance tests with effect size measures and confidence intervals is shown to address some but not necessarily all problems associated with multiple testing.
498 citations