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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Literature on cocaine-dependent patients studied through psychological testing remains limited, while there is much on assessment of alcoholics. This study replicated previous evaluation of cocaine-dependent patients, now compared with a group of alcoholics. Seventy-eight male and 21 female cocaine dependents and 70 male and 24 female alcoholics, hospitalized in a dual diagnosis program, were administered the MMPI, Millon Clinical Multiaxial Inventory-II (MCMI-II), Rorschach, Beck Depression Inventory, and Shipley Institute of Living Scale, after a 2-week stabilization period. Test data were statistically analyzed and compared along with demographic information. Cocaine-addicted subjects were younger, more often single and Afro-American, of lower socioeconomic status, less educated, and had slightly lower intellectual functioning and lesser family occurrence of addiction than alcoholics. Patients dependent on cocaine showed statistically more distress and psychopathology. Both groups demonstrated a high occurrence of personality disorders, but with different patterns of diagnoses. Implications for further research and treatment are discussed.
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PMID:Psychopathology in alcohol- and cocaine-dependent patients: a comparison of findings from psychological testing. 845 May 74

This study examined the reliability, validity, and responsiveness of Lehman's Quality of Life Interview (QOLI) as an outcome measure on 981 acutely ill psychiatric inpatients assessed longitudinally at admission and discharge. Patients were stratified into five diagnostic (DX) (depressed bipolar, depressed unipolar, schizophrenia, mania, and other diagnoses) and two substance use disorder (SA) strata (with and without concurrent substance abuse/dependence) based on DSM-III-R criteria. There was good replication of the factor structure, excellent internal consistency, overall and within DX and SA groups. Intercorrelations showed that the functional and satisfaction indices measure unique aspects of the quality of life. The construct consistency of the QOLI was dependent upon psychiatric diagnosis and life domain. Intercorrelations of functional and satisfaction indices for patients with depression were greater than for manic patients. We demonstrated strong consistency of construct validity for family and social relation domains, but not safety or leisure activities. Construct validity was shown to hold longitudinally. Analyses of DX and SA group differences on satisfaction and functional indices of the 8 life domains supported discriminative validity: Depressed patients reported the most dissatisfaction, followed by schizophrenic patients, and manic patients reported the greatest satisfaction in most life domains. Patients with concurrent substance abuse generally reported less satisfaction and lower quality of life than patients without a dual diagnosis. Examination of longitudinal changes in satisfaction indicated the QOLI is responsive to changes in global life, leisure activities, living situation, and social relations from hospital admission to discharge (an average of 2 weeks). This study supports the use of the QOLI as an outcome measure to assess quality of life in acutely ill hospitalized psychiatric patients.
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PMID:Longitudinal assessment of quality of life in acute psychiatric inpatients: reliability and validity. 909 98

Recent evidence indicates persons 60 years and over experience significant alcohol and substance abuse problems. Since a combination of alcoholism and depression is likely to increase the relative rsk of suicide, it is important to examine the prevalence of dual diagnosis in older adults. The purpose of this study is to examine the prevalence and correlates of dual diagnosis in older psychiatric inpatient populations and compare our results with findings from studies of younger hospitalized dually diagnosed patients. A retrospective chart audit was performed on 101 elders who were discharged from three psychiatric hospitals. Clinical variables that were examined included length of hospital stay, psychiatric and medical diagnoses, medications and history of suicidal ideation or intent. The leading psychiatric disorder diagnosis for our sample of hospitalized psychiatric elders was depression. Over one-third (37.6%) had a substance abuse disorder in addition to a psychiatric disorder, and almost three-fourths (71%) of this 'dual diagnosis' group abused alcohol and 29% abused both alcohol and other substances. In addition, significantly more elders in the "dual diagnosis' group (17.7%) than in the group with only a mental disorder diagnosis (3.3%) made a suicide attempt prior to admission to the hospital. Because, affective disorders in conjunction with alcohol abuse are the most frequently found disorders in completed suicides, our findings have important relevance for the advocating of routine use of diagnostic assessment and screening for both substance abuse and mental disorders in this population.
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PMID:Dual diagnosis in elders discharged from a psychiatric hospital. 915 13

Primary socialization theory proposes that drug use and deviant behaviors emerge from interactions with the primary socialization sources--the family, the school, and peer clusters. The theory further postulates that the individual's personal characteristics and personality traits do not directly relate to drug use and deviance, but, in nearly all cases, influence those outcomes only when they affect the interactions between the individual and the primary socialization sources. Interpretation of research results from the point of view of primary socialization theory suggests the following: 1) Characteristics such as depression, anxiety, and low self-esteem are related to drug use and deviance only when they have strong effects on the primary socialization process, i.e., among younger children; 2) Traits such as anger, aggression, and sensation seeking are related to drug use and deviance because these traits are more likely to influence the primary socialization process at all ages; 3) The psychopathologies that are least likely to interfere with bonding with prosocial socialization sources, the anxieties and most of the affective disorders, are less likely to have comorbidity drug dependence; and 4) Psychopathologies such as oppositional disorder, conduct disorder, attention deficit disorder, and antisocial personality are more likely to interfere with primary socialization, and the literature shows that these syndromes are also most likely to have a dual diagnosis with drug dependency.
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PMID:Primary socialization theory. The role played by personal traits in the etiology of drug use and deviance. II. 960 74

Whether the Psychopathology Inventory for Mentally Retarded Adults (PIMRA) could detect specific psychopathological disorders was investigated in 652 subjects with different levels of mental retardation living in the community or in residential facilities. An exploratory factor analysis was carried out to check the scale organization of PIMRA. The Anxiety, Adjustment Disorder, Somatoform Disorder, and Soundness Scales were confirmed by 4 corresponding factors; the Psychosexual Disorder Scale was replaced by a factor specific to gender identity problems, and the Schizophrenia Scale by two factors concerning isolation and bizarre behaviors, respectively. The items of the Depression Scale were distributed over the three factors concerning anxiety, adjustment, and psychosomatic disorders, while the items of the Personality Disorder Scale were scattered over almost all the factors. Moreover, 55 subjects with anxiety disorders and 49 with depression were compared to 50 control subjects of the same age, intelligence level, and gender ratio but without dual diagnosis and obtained significantly higher factorial scores both on the overall scale and on the factors specifically related to their disorders. PIMRA has been found to show good construct validity. These results could be considered particularly valid as they were obtained from a large sample comprising different levels of mental retardation and thus showing all possible psychopathological behaviors.
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PMID:The psychopathology inventory for mentally retarded adults: factor structure and comparisons between subjects with or without dual diagnosis. 1098 85

Sixty-eight male and female individuals with both DSM-IV diagnoses of cocaine dependence and major depressive disorder were randomly assigned to one of two medication conditions (placebo vs. 40 mg per day) as part of a double-blind, placebo-controlled clinical efficacy trial of fluoxetine for the treatment of this dual diagnosis. During the 12-week outpatient treatment phase all participants also received individual cognitive-behavioral psychotherapy targeting both cocaine use and depression. Depressive symptoms remitted as a function of time in treatment, with no significant medication effects found. Fewer cocaine positive urines were found during the first 6 weeks of treatment in the placebo group compared with the 40-mg group. Cocaine use and depressive symptoms during treatment were significantly correlated. The findings fail to support the role of fluoxetine for treatment of cocaine use and depression in dually-diagnosed patients.
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PMID:Fluoxetine treatment of cocaine-dependent patients with major depressive disorder. 1141 25

The purpose of this study was to assess a 4-month inpatient treatment program based on integrated models for patients with substance use and psychiatric disorders (dual diagnosis patients). On admission and at the 1-year follow-up, a consecutive sample of 118 dual diagnosis patients who entered the program were assessed by interview. Eighty-four patients (70.6%) completed the 1-year follow-up interview, reporting less frequent substance use, less severe psychiatric symptoms, a lower rehospitalization rate, and better housing conditions than on admission. Patients diagnosed with a comorbid personality disorder had a better improvement in the frequency of drinking and were less likely to be rehospitalized than patients with schizophrenia or depression. The results suggest that the integrated inpatient program may be a promising treatment approach for dual diagnosis patients. The results await replication in controlled studies that need to include an assessment of outpatient treatment following inpatient programs.
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PMID:One-year follow-up of dual diagnosis patients attending a 4-month integrated inpatient treatment. 1181 91

This article highlights the centrality of gender to mental health nursing practice by providing evidence that gendered assumptions are embedded in psychiatric knowledge. After a brief account of gendered rates of mental illness, the first two-thirds of this article explores formal psychiatric diagnostic criteria, casebook specificity, and processes involved in gaining a psychiatric diagnosis in relation to gender. In contemporary psychiatric practice the two tendencies of overdiagnosis and underdiagnosis are simultaneously evident, with woman-predominant styles of expressing distress being particularly associated with underdiagnosis. The final sections of the article outline gendered attitudes and expectations that impact on clients and their treatment, along with common gendered differences relevant to mental health nursing and people living with anxiety, depression, substance abuse, psychosis, and dual diagnosis.
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PMID:Gender and mental illness: an Australian overview. 1188 57

Studies of so-called 'dual diagnosis', i.e. intellectual disability (ID) with an additional psychiatric disorder, are reviewed with particular reference to offending behaviour. Because of the paucity of studies of psychopathology in offenders with ID, the present paper opens with studies of broader issues of psychopathology among people with ID, notably those with depression, schizophrenia, mild depressive disorder, other major psychotic disorders, anxiety/neurotic disorder, autistic spectrum disorders and attention deficit hyperactivity disorder. There follows a review of the most established and commonly used measurement scales for dual diagnosis in ID. The review then focuses directly on those studies which have looked at the issues of dual diagnosis among offenders with ID. In keeping with other reviews in this series, the latter studies are classified according to the same criteria. Based on this review, it is apparent that there are high-priority research questions which concern the extent and nature of psychopathology among offenders with ID, most notably those with autistic spectrum disorders.
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PMID:Dual diagnosis in offenders with intellectual disability: setting research priorities: a review of research findings concerning psychiatric disorder (excluding personality disorder) among offenders with intellectual disability. 1203 Oct 15

This study describes failure to seek health care among 673 new adult clients seeking mental health services in the San Francisco Bay area. Overall, 49% (n = 328) reported a failure to seek health care they believed was needed in the past year. People with dual diagnosis, severe depression, chronic physical illness, fear of coercive treatment, private insurance, and no insurance were more likely to fail to seek health care. Greater use of private physicians decreased the odds of failure to seek health care. These findings highlight the need to target groups at risk for failure to seek health care and the need to design nonthreatening programs to improve health access for people with mental illness.
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PMID:Failure to seek health care among the mentally ill. 1570 50


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