摘要:

In Part I, the authors described the philosophy and organizational concerns of a public inpatient unit for the stabilization and treatment of acute dual diagnosis patients. In this pilot report, clinical experience with 70 consecutively referred alcohol‐dependent psychiatric inpatients was retrospectively reviewed and findings were contrasted with 70 primarily alcohol‐dependent referrals (controls). Demographic and patient‐care variables were examined to elucidate some of the special needs of these “dually diagnosed” patients. The results show that psychiatrically referred patients have fewer social and professional supports, higher rates of homelessness, earlier ages at onset, and more comorbid chemical dependency than the alcohol‐dependent referrals. Psychiatrically referred patients required more staff intervention and had more inpatient problems th

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00418.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Thirty‐two cocaine‐dependent methadone‐maintained patients received an 8‐week course of auricular acupuncture for the treatment of cocaine dependence. Fifty percent completed treatment; 88% of study completers attained abstinence, defined as providing cocaine‐free urine samples for the last 2 weeks of the study, yielding an overall abstinence rate of 44%. Abstainers reported decreased depression, a shift in self‐definition, decreased craving, and increased aversion to cocaine‐related cues. Post‐hoc comparisons to pharmacotherapy with desipramine (DMI), amantadine (AMA), and placebo revealed a higher abstinence rate for acupuncture (44%) than for AMA (15%) or placebo (13%), but not significantly higher tha

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00419.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Significant differences in the phenomenology ofpsychopathology were found between male and female substance abusers. Women reported higher rates of utilization of mental health services (t‐test, P<0.0026) and had more depressive traits. Male substance abusers had significantly higher rates of sociopathy (t‐test, P<0.0368). Women had a higher prevalence of benzodiazepine abuse (χ2= 9.62, P<0.01). The trend in our findings was that men tended to be antisocial and alcoholic, and women were more likely to express dysphoria and abuse drugs other than alcohol. The gender effect on comorbidity may affect the presentation of individual cases and subsequent treatment stra

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00420.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Ninety‐eight male patients on methadone maintenance treatment provided weekly urine screens for typical substances of abuse and periodic screens for 9‐carboxy‐tetrahydrocannabinol (THC). Although different in some demographics and personality characteristics, patients who were THC‐positive (THC+; n = 54, 55.1%) were no more likely to use other illicit drugs and showed similar treatment retention, employment, and cognitive function to those who were THC‐negative. THC+ patients reported more marijuana use at admission. Marijuana use exhibits no apparent impact on methadone treatment outcome. Routine urine screening for THC in methadone programs is not currently

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00421.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Routine HIV (human immunodeficiency virus) testing of high‐risk groups (i.e., substance‐abusing individuals) could help decrease the spread of AIDS (acquired immune deficiency syndrome). Such a policy, however, could deter individuals from entering treatment, paradoxically increasing the likelihood of the disease being spread. The authors examined the willingness of substance‐abusing individuals to consent to HIV testing by randomly assigning patients entering either a drug‐free outpatient program or a methadone maintenance program to one of three informed consent conditions differing in degree of perceived coerciveness. Overall, 69% of the patients agreed to testing. As hypothesized, the proportion of agreement was highest under the most coercive informed consent condition. Although the results tend to support continuation of voluntary testing programs, only 5.5% of patients asked indicated that mandatory testing would have deterred them from entering tr

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00422.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Male offspring, ages 12–17, of alcoholic and normal social‐drinking men were compared on a battery of tests measuring intellectual ability, academic achievement, and learning and memory. The sons of alcoholic men were found to have significantly lower verbal IQ and achievement scores but did not perform more poorly on tests of learning and mem

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00423.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Familial risk for psychiatric disorders was assessed among 673 siblings of cocaine‐abusing individuals. Various indices of familial risk were examined, including those based on the presence/absence of disorders in parents and those reflecting severity (assessed by age at onset) of disorders. Across risk indices, the findings indicated high vulnerability among siblings (1) to substance abuse in relation to paternal alcoholism and (2) to depression and substance abuse in relation to maternal depression. The validity of the Type I/Type II distinction was upheld in the context of alcoholism only among fathers. In the context of affective disorders, risk to offspring was greatest if exposure to parental psychopathology occurred during the early childhood year

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00424.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This “matching” study attempts to determine characteristics of adolescent drug abuse patients that may determine whether an inpatient or an outpatient treatment setting will be more effective or more suitable for meeting the needs of the patient. Compared to short‐term inpatient treatment, long‐term outpatient treatment was shown to have significantly greater effect in reducing substance use/abuse for patients who had relatively more severe social lifestyle problems, family problems, and employment problems. Outpatient treatment even showed a trend toward a significantly better outcome for patients with more severe psychiatric p

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00425.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In this double‐blind controlled study, 143 opioid‐dependent male subjects were detoxified and randomly assigned to etrafon (amitriptyline 25 mg and perphenazine 2 mg), methadone, or placebo. Subjects were treated, monitored, and evaluated frequently for 1 year. Reported here are assessments carried out at 3‐month intervals after hospital discharge. Treatment effectiveness was defined in terms of improvement of clinical symptoms, employment, and reduction in drug abuse. Data were analyzed on subjects who remained in treatment for at least 3 months (73%). Data analysis used a random regression model. Overall, type of treatment did not significantly affect outcome. An unexpected but significant effect on outcome seemed due to adherence to drug regimen. Those who adhered to their medication, whether etrafon, methadone, or placebo, improved more than noncompliers on most outcome measures regardless of type of drug trea

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00426.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The Teen Addiction Severity Index (T‐ASI) is a semistructured interview that was developed to fill the need for a reliable, valid, and standardized instrument for periodic evaluation of adolescent substance abuse. A preliminary study indicated good clinical utility and satisfactory interrater reliability. This study had three objectives: 1) to determine whether the T‐ASI discriminated between hospitalized psychiatric patients with and without comorbid psychoactive substance use disorders (PSUD); 2) to determine whether T‐ASI scores were related to other indices of problem behavior; and, 3) to determine whether there was any specificity in the ratings of different domains of the instrument when compared with other criteria. The results of the study provide support for the good psychometric properties of the

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1993.tb00427.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY