Psychosocial Interventions for People With Both Severe Mental Illness and Substance Misuse
TLDR
There was no consistent evidence to support any one psychosocial treatment over another and more quality trials are required that adhere to proper randomization methods; use clinically valuable, reliable, and validated measurement scales; and clearly report data, including retention in treatment, relapse, and abstinence rates.Abstract:
Over 50% of people with a severe mental illness also use illicit drugs and/or alcohol at hazardous levels. This review is based on the findings of 32 randomized controlled trials which assessed the effectiveness of psychosocial interventions, offered either as one-off treatments or as an integrated or nonintegrated program, to reduce substance use by people with a severe mental illness. The findings showed that there was no consistent evidence to support any one psychosocial treatment over another. Differences across trials with regard to outcome measures, sample characteristics, type of mental illness and substance used, settings, levels of adherence to treatment guidelines, and standard care all made pooling results difficult. More quality trials are required that adhere to proper randomization methods; use clinically valuable, reliable, and validated measurement scales; and clearly report data, including retention in treatment, relapse, and abstinence rates. Future trials of this quality will allow a more thorough assessment of the efficacy of psychosocial interventions for reducing substance use in this challenging population.read more
Citations
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Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders
Cherrie Galletly,David J. Castle,Frances Dark,Verity Humberstone,Assen Jablensky,Eoin Killackey,Jayashri Kulkarni,Patrick D. McGorry,Olav Nielssen,Nga Tran +9 more
TL;DR: This guideline takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function, and uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care.
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Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990-2014: a systematic review and meta-analysis
TL;DR: The strong association between SUDs, mood and anxiety disorders is confirmed worldwide as a factor that affects the profile, course, patterns, severity and outcomes of these disorders.
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Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology:
TL;DR: These guidelines from the British Association for Psychopharmacology address the scope and targets of pharmacological treatment for schizophrenia, and cover the pharmacological management and treatment of schizophrenia across the various stages of the illness.
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Intensive case management for severe mental illness
TL;DR: There was moderate-quality evidence that ICM probably makes little or no difference in reducing death by suicide, and overall quality for clinically important outcomes using the GRADE approach, and possible risk of bias within included trials.
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Psychosocial Treatments for Schizophrenia
TL;DR: The current state of the literature regarding psychosocial treatments for schizophrenia is reviewed within the frameworks of the recovery model of mental health and the expanded stress-vulnerability model.
References
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