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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examined the contribution of neuropsychological functioning to the attainment of treatment objectives in substance abuse patients. Subjects were 85 patients enrolled in comprehensive, inpatient and outpatient substance abuse treatment at a VA Medical Center. Most subjects were diagnosed with Alcohol Dependence or Abuse, and nearly half were seeking treatment for Cocaine Dependence or Abuse. After acute detoxification, but before beginning individualized treatment, subjects were administered a neuropsychological screening battery to assess cognitive functioning and affective status. They then attended a variety of daily group therapies. Each therapy group had its own set of specific treatment objectives; on each treatment day, group therapists rated each patient's attainment of the specific objectives for their group. Groups included Assertiveness Training (Levels I and II), Stress Management (Levels I and II), Social Skills Training, Job Skills, Relapse Prevention (Levels I and II), Leisure Planning, Leisure Skills, Occupational Therapy, and 12-Step Study. Stepwise multiple regression indicated that the best predictors of overall objective attainment were better attention (WMS-R Digits Backwards) and less depressive symptomatology (Beck Depression Inventory). These results suggest that attention and mood have a modest yet significant impact on the success of treatment interventions for substance abuse patients. Thus, evaluation of cognitive as well as affective factors in substance abuse patients might be helpful in designing and implementing specialized interventions to maximize the likelihood of treatment success.
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PMID:Neuropsychological predictors of the attainment of treatment objectives in substance abuse patients. 1126 24

We examined the occurrence of violent traumatic events, DSM-III-R diagnosis of posttraumatic stress disorder (PTSD), and PTSD symptoms, and the relationship of these variables to drug abuse severity. One-hundred fifty opioid-dependent drug abusers who were participants in a randomized trial of two methadone treatment interventions were interviewed using the Diagnostic Interview Schedule, the Addiction Severity Index, and the Beck Depression Inventory. Twenty-nine percent met diagnostic criteria for PTSD. With the exception of rape, no gender differences in the prevalence of violent traumatic events were observed. The occurrence of PTSD-related symptoms was associated with greater drug abuse severity after controlling for gender, depression, and lifetime diagnosis of PTSD. The high rate of PTSD among these methadone patients, the nature of the traumatic events to which they are exposed, and subsequent violence-related psychiatric sequelae have important implications for identification and treatment of PTSD among those seeking drug abuse treatment.
J Subst Abuse Treat 2001 Mar
PMID:Violent traumatic events and drug abuse severity. 1130 14

Abuse of the anaesthetic agent propofol (2,6-diisopropylphenol) is rare, but we report a case of a 26-year-old male nurse in which the autopsy showed unspecific signs of intoxication and criminological evidence pointed towards propofol abuse and/or overdose. Intravenously administered propofol is a fast and short-acting narcotic agent, therefore it seemed questionable whether the deceased would have been able to self-administer a lethal overdose before losing consciousness. The blood and brain concentrations corresponded to those found 1-2 min after bolus administration of a narcotic standard dose of 2.5 mg propofol/kg body weight. Extremely high propofol concentrations were found in the urine indicating excessive abuse before death. However, due to the short half-life of propofol, the cumulative effects of repeated injections should not be relevant for toxicity, since this would result in a blood level increase of only 1-2 micrograms/ml. Furthermore, the detection and quantitation of propofol in three different hair segments indicated chronic propofol abuse by the deceased. The results of the investigation suggest that death was not caused by a propofol overdose but by respiratory depression resulting from overly rapid injection.
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PMID:Death after excessive propofol abuse. 1135 4

Lifetime substance abuse comorbidity is frequent in schizophrenic patients, but the clinical correlates remain unclear. We have explored the chronological relations between substance abuse and course of schizophrenia, and compared several clinical characteristics and personality dimensions in 50 schizophrenic patients with or without lifetime substance abuse or dependence. Abuse occurred mainly after the first prodromal symptoms and just before the first psychotic episode. Substance-abusing patients were not different from non-substance-abusing patients on the Chapman Physical Anhedonia Scale, PANSS total score, negative subscore or depression item, CGI, treatment response and demographic variables. In contrast, substance-abusing patients had higher scores on the Barratt Impulsivity Scale (total, cognitive and non-planning scores) and had attempted suicide more often. In patients with schizophrenia, as in the general population, substance abuse or dependence appears associated with higher impulsivity and suicidality. High impulsivity could facilitate substance abuse as a maladaptive behavior in response to prodromal symptoms, precipitating the onset of a characterized psychosis.
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PMID:Substance abuse and suicidality in schizophrenia: a common risk factor linked to impulsivity. 1136 41

The Beck Depression Inventory-II (BDI-II) was administered to 416 consecutive male admissions to a 28-day residential chemical dependence treatment program as part of a routine intake procedure. Psychometric analyses revealed that the BDI-II scores were internally consistent in this treatment-seeking population based on coefficient alpha. The mean BDI-II score for patients in this study was higher than that noted for other clinical samples in previous studies. The use of the BDI-II for clinical decision making with chemically dependent individuals is discussed in light of this elevated distribution of scores. Confirmatory factor-analytic examinations of the instrument revealed that a three-factor model, with cognitive, affective, and somatic symptoms loading as separate factors, provided the most adequate account of the data. In total, the study supported the use of the BDI-II for the assessment of depression in chemically dependent male patients entering a residential treatment program at a VAMC facility, provided population-specific normative data is utilized for making clinical decisions.
J Subst Abuse Treat 2001 Apr
PMID:A psychometric evaluation of the BDI-II in treatment-seeking substance abusers. 1151 88

Individuals (n = 39) participated in an outpatient, 16-session individual, manual-guided psychotherapy designed to treat concurrent PTSD and cocaine dependence. Therapy consisted of a combination of imaginal and in-vivo exposure therapy techniques to treat PTSD symptoms and cognitive-behavioral techniques to treat cocaine dependence. Although the dropout rate was high, treatment completers (i.e., patients who attended at least 10 sessions; n = 15) demonstrated significant reductions in all PTSD symptom clusters and cocaine use from baseline to end of treatment. Significant reductions in depressive symptomatology, as measured by the Beck Depression Inventory, and psychiatric and cocaine use severity, as measured by the Addiction Severity Index, were also observed. These improvements in PTSD symptoms and cocaine use were maintained over a 6-month follow-up period among completers. The average pre- to posttreatment effect size was 1.80 for PTSD symptoms and 1.26 for drug and alcohol use severity. Baseline comparisons between treatment completers and noncompleters revealed significantly higher avoidance symptoms, as measured by the Impact of Events Scale, and fewer years of education among treatment noncompleters as compared to completers. This study provides preliminary evidence to suggest that exposure therapy can be used safely and may be effective in the treatment of PTSD in some individuals with cocaine dependence. However, the study is limited by the uncontrolled nature of the study design, small number of subjects, and high dropout rate.
J Subst Abuse Treat 2001 Jul
PMID:Exposure therapy in the treatment of PTSD among cocaine-dependent individuals: preliminary findings. 1151 26

According to the Therapeutic Community (TC) treatment approach, social affiliation with the drug-free peer community is the basis for patients initiating therapeutic change. A total of 322 TC residents were assessed with regard to social affiliation, acceptance of TC philosophy, perceived benefit of program components, level of depression, and length of time in treatment. Residents exhibited a higher level of affiliation with TC members than with untreated substance abusers they knew outside the program. Being female, and separated from a spouse, were each associated with a higher level of TC member affiliation. After controlling for sociodemographic characteristics, two variables emerged as unique significant correlates of affiliation: perceived benefit for recovery of TC treatment was associated with greater TC member affiliation, whereas level of depression was inversely correlated. These findings are interpreted in relation to the goals of the TC process and to implications for treatment.
J Subst Abuse Treat 2001 Sep
PMID:The role of social cohesion among residents in a therapeutic community. 1155 39

A retrospective record review of one year of admissions to a residential adolescent substance abuse treatment program (N = 91) examined the prevalence of comorbid psychiatric disorders and factors associated with successful treatment participation. Psychiatric and substance use disorders (SUD) were diagnosed by DSM-IV criteria. Successful participation was based on multiple factors assessed by the treatment team. Consistent with prior studies, there was considerable comorbidity (63.7%) with both disruptive (Attention Deficit Hyperactivity Disorder [ADHD], 11%; Conduct Disorder [CD], 24%) and other disorders (depression, 24%; adjustment disorder, 7.7%; bipolar disorder, 3.3%). Male gender was negatively associated (OR = 0.23, P = 0.019) with successful participation in univariate analyses, as was ADHD (OR = 0.18, P = 0.007). CD (OR = 0.37, P = 0.053) approached significance. Multivariate analysis reveals ADHD was significant while having CD and being male approached significance. Psychotropic medication use and other diagnoses were not associated with successful participation. It is concluded that further research on the relationship between ADHD, CD, and substance abuse treatment is needed.
J Subst Abuse Treat 2001 Oct
PMID:Dual diagnosis and successful participation of adolescents in substance abuse treatment. 1172 90

This study examined the influence of psychological factors and personal characteristics on depression and health outcomes of battered Black women. Much of the existing research on violence against women by intimate partners has focused on prevalence and response to abuse. However, the problem of battering among Black women as a group has been neglected, especially as it impacts health and causes health-related problems. Secondary analysis was used in this study to look at health-related problems and battering. The sample consisted of 128 battered Black women who participated in interviews, and completed the Beck Depression Index, Health Response Scale, Daily Hassles Scale, and Index of Spouse Abuse. Study outcomes indicated a positive relationship between depression and gastrointestinal upsets. Further study with a larger group of women is needed to validate findings.
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PMID:Self-reported health status and depression of battered black women. 1176 May 17

The purpose of this study was to investigate parenting received in childhood and early separation anxiety experiences in young male soldiers with adjustment disorder. Fifty-four conscripts suffering from adjustment disorder completed the following questionnaires: the Symptom Checklist-90-Revised (SCL-90-R), the Measurement of Parental Style (MOPS), and the Separation Anxiety Symptom Inventory (SASI). Seventy-eight conscripts, matched for age and education, were used as a control sample. The research showed that compared with the controls, patients had significantly increased scores on the SCL-90-R (p < 0.001), the SASI (p < 0.03), and the father's and mother's MOPS Abuse subscale (p < 0.001). The father's MOPS Abuse score, the mother's MOPS Overcontrol score, and the SASI score were also significantly correlated with the SCL-90-R score (p < 0.01). Finally, a patient's separation anxiety can be predicted from the mother's overcontrol behavior, and the severity of the disorder can be predicted from the father's abuse behavior. These findings are in agreement with previous findings in patients with depression and anxiety disorders.
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PMID:Parenting received in childhood and early separation anxiety in male conscripts with adjustment disorder. 1179 9


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