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Venkatesh U, Aparnavi P, Mogan K, Durga R, Pearson J, Kishore S, Joshi HS, Nair NS, Nisha B, Agrawal R, Vidusha K, Chenkual CV, Nath B, Epari VR, Kumari R, Goyal P, Ahamed F, Baruah M, Anil R, Swami AA, Kamble BD, Sharma GA, Sharma A, Bera OP, Grover A, Verma SK. Determinants of substance use among young people attending primary health centers in India. Glob Ment Health (Camb) 2024; 11:e23. [PMID: 38572250 PMCID: PMC10988150 DOI: 10.1017/gmh.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/14/2023] [Accepted: 01/24/2024] [Indexed: 04/05/2024] Open
Abstract
Background Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.
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Affiliation(s)
- U. Venkatesh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - P. Aparnavi
- Kovai Medical Center and Hospital Institute of Health Sciences and Research, Coimbatore, India
| | - K.A. Mogan
- South Asia Field Epidemiology and Technology Network, Inc., Metro Manila, Philippines
| | - R. Durga
- Department of Dentistry, All India Institute of Medical Sciences, Gorakhpur, India
| | | | - Surekha Kishore
- All India Institute of Medical Sciences (AIIMS), Gorakhpur, India
| | - Hari Shanker Joshi
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | | | - B. Nisha
- Saveetha Medical College and Hospital, Kuthambakkam, India
| | | | | | | | - Bhola Nath
- All India Institute of Medical Sciences, Raebareli, India
| | | | | | - Pooja Goyal
- Employment State Insurance Corporation Medical College and Hospital, Faridabad, India
| | - Farhad Ahamed
- All India Institute of Medical Sciences, Kalyani, India
| | | | - R. Anil
- PES Institute of Medical Sciences and Research, Beggilipalle, India
| | | | | | | | - Akash Sharma
- Department of Medicine, University at Buffalo – Catholic Health System, Buffalo, NY, USA
| | | | - Ashoo Grover
- Indian Council of Medical Research, New Delhi, India
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Graves BD, Mowbray O, Aletraris L, Paseda O, Dias C. Examining Correlates of Substance Use Treatment Needs for Adults Under Community Supervision. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231198804. [PMID: 37752880 DOI: 10.1177/0306624x231198804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Substance use among criminal justice-involved adults is a significant concern for the rehabilitation and reintegration into their communities. Few have examined broader associations with substance use among those in probation or parole (community supervision) using an assessment of risks and needs with a representative sample. Using an assessment based on risk-need-responsivity principles, this research applies negative binomial analyses to examine sociodemographic, criminal, and other problem-area correlates of substance use risks and needs among a statewide dataset of adults in community supervision. Results indicated that mental health risk/need was the strongest predictor of substance use risk/need. Other risk areas, including criminal thinking, employment/education, and the presence of delinquent associates (peers/family) were associated with substance use. Implications highlight the ongoing call to develop integrated models of care that treat co-occurring disorders among adults in supervision. Additionally, diversion-oriented efforts that prevent adults with complex treatment needs from reentering the justice system are discussed.
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Affiliation(s)
- Brian D Graves
- University of Georgia School of Social Work, Athens, USA
| | - Orion Mowbray
- University of Georgia School of Social Work, Athens, USA
| | | | | | - Clarissa Dias
- State of Georgia Department of Community Supervision, Atlanta, USA
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Dong KR, Chen X, Stopka TJ, Must A, Beckwith CG, Tang AM. Food Access, Dietary Intake, and Nutrition Knowledge of Adults on Probation. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:510-520. [PMID: 35618404 PMCID: PMC9186298 DOI: 10.1016/j.jneb.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To examine food access, dietary intake, and perceptions about diet and associations with health among adults on probation. DESIGN Using a mixed-methods approach, interviews were used to understand food access, dietary intake, and diet and associations with health. A survey measured self-assessed diet quality and diet and associations with health. SETTING One probation office in Rhode Island. PARTICIPANTS English-speaking adults on probation in 2016 (n = 22 interviews, n = 304 surveys). MAIN OUTCOME MEASURE(S) Food access, dietary intake, knowledge about diet and health, and perceptions about healthy food. ANALYSIS We used a thematic analytic approach to analyze the interviews. Descriptive statistics were performed for the survey. RESULTS Many interviewees had inadequate food access, although most participated in the Supplemental Nutrition Assistance Program, and some received food from food banks. Interviewees primarily shopped at grocery stores and prepared food at home, and dietary intakes did not meet the 2020-2025 Dietary Guidelines for Americans. Almost two-thirds (64.2%) of survey participants reported good or fair diet quality. Based on the survey results, the majority of participants strongly agreed and agreed with the statements, "The types of foods I eat affect my health" and "The types of food I eat affect my weight." CONCLUSIONS AND IMPLICATIONS This study identified low-quality dietary intake and food acquisition strategies, such as shopping sales, buying bulk, and going to multiple stores, by US adults on probation to access food with limited resources. Participants reported interest in eating healthier foods and knew there was a connection between dietary intake and health. These data support addressing ways to improve food access and dietary quality, focusing on future programs and policies for this population.
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Affiliation(s)
- Kimberly R Dong
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
| | - Xuemeng Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Thomas J Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Curt G Beckwith
- Division of Infectious Diseases, Alpert Medical School of Brown University, The Center for AIDS Research, The Miriam Hospital, Providence, RI
| | - Alice M Tang
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
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Edwards L, Jamieson SK, Bowman J, Chang S, Newton J, Sullivan E. A systematic review of post-release programs for women exiting prison with substance-use disorders: assessing current programs and weighing the evidence. HEALTH & JUSTICE 2022; 10:1. [PMID: 34978645 PMCID: PMC8725487 DOI: 10.1186/s40352-021-00162-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/04/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND The rising rates of women in prison is a serious public health issue. Unlike men, women in prison are characterised by significant histories of trauma, poor mental health, and high rates of substance use disorders (SUDs). Recidivism rates of women have also increased exponentially in the last decade, with substance related offences being the most imprisoned offence worldwide. There is a lack of evidence of the effectiveness of post-release programs for women. The aim of this systematic review is to synthesise and evaluate the evidence on post-release programs for women exiting prison with SUDs. METHODS We searched eight scientific databases for empirical original research published in English with no date limitation. Studies with an objective to reduce recidivism for adult women (⩾18 years) with a SUD were included. Study quality was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB2) and the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tools. RESULTS Of the 1493 articles, twelve (n = 3799 women) met the inclusion criteria. Recidivism was significantly reduced in five (42%) programs and substance-use was significantly reduced in one (8.3%) program. Common attributes among programs that reduced recidivism were: transitional, gender-responsive programs; provision of individualised support; providing substance-related therapy, mental health and trauma treatment services. Methodological and reporting biases were common, which impacted our ability to synthesize results further. Recidivism was inconsistently measured across studies further impacting the ability to compare results across studies. CONCLUSIONS Recidivism is a problematic measure of program efficacy because it is inconsistently measured and deficit-focused, unrecognising of women's gains in the post-release period despite lack of tailored programs and significant health and social disadvantages. The current evidence suggests that women benefit from continuity of care from prison to the community, which incorporated gender-responsive programming and individualised case management that targeted co-morbid mental health and SUDs. Future program design should incorporate these attributes of successful programs identified in this review to better address the unique challenges that women with SUDs face when they transition back into the community.
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Affiliation(s)
- Layla Edwards
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Sacha Kendall Jamieson
- Sydney School of Education and Social Work, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
- School of Public Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Julia Bowman
- Research Operations Manager, Research Unit, Justice Health and Forensic Mental Health Network, Malabar, NSW, 2036, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
- School of Public Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Sungwon Chang
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Josie Newton
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Elizabeth Sullivan
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
- Acting Deputy Vice Chancellor Research, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Custodial Health Justice Health and Forensic Mental Health Network, Malabar, NSW, 2036, Australia.
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Kontu M, Hakko H, Riala K, Riipinen P. Adolescence Predictors for Drug Crime Offending: A Follow-up Study of Former Adolescent Psychiatric Inpatients. Community Ment Health J 2021; 57:736-745. [PMID: 32910370 PMCID: PMC7981305 DOI: 10.1007/s10597-020-00708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/02/2020] [Indexed: 11/26/2022]
Abstract
Our aim was to examine adolescent predictors (family- and school-related factors, substance use, and psychiatric disorders) for drug crime offending. The initial study population consisted of 508 former adolescent psychiatric inpatients aged between 13 and 17 years. Of them, 60 (12%) had committed a drug crime by young adulthood and they were matched with 120 (24%) non-criminal controls by sex, age and family type. During adolescent hospitalization, study participants were interviewed using valid semi-structured research instruments. Criminal records were obtained from the Finnish Legal Register Centre up to young adulthood. A distant relationship with a father, lying, and thieving, moderate/high nicotine dependence and weekly use of stimulants were shown to be the most prominent predictors for drug crime offending. Our findings encourage the use of modern child- and family-centered approaches in preventing youth involvement in illegal drug use and drug crimes.
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Affiliation(s)
- Mikaela Kontu
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O.Box 5000, 90014, Oulu, Finland.
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Kaisa Riala
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Pirkko Riipinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O.Box 5000, 90014, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Pinals DA, Gaba A, Shaffer PM, Andre MA, Smelson DA. Risk-need-responsivity and its application in behavioral health settings: A feasibility study of a treatment planning support tool. BEHAVIORAL SCIENCES & THE LAW 2021; 39:44-64. [PMID: 33569766 DOI: 10.1002/bsl.2499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/30/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
The risk-need-responsivity (RNR) model suggests several key practices for justice-involved populations under correctional supervision. Behavioral health treatment planning aligned with RNR principles for offender populations with co-occurring mental health and substance use disorders (CODs) could be one method for integrating RNR into clinical care. To explore a unique approach to working with behavioral health and RNR principles, the authors implemented a mixed-methods feasibility study of the acceptability, usability, and utility of a newly developed RNR treatment planning support tool (RNR TST). The tool was implemented in a re-entry program serving adults with co-occurring mental health and opioid use disorders. Chart reviews of RNR TSTs (N = 55) and a focus group (N = 14 re-entry clinical staff) were conducted. Ninety-six percent of the RNR TSTs incorporated the use of a validated risk-need assessment and 70% of the RNR TSTs were semi-complete to complete. Focus group interviews highlighted behavioral health staff perspectives on the acceptability, usability, and utility of the RNR TST. This novel RNR TST has the potential to assist behavioral health providers in integrating RNR principles into treatment planning. Further development and testing are needed to determine its impact on client care and outcomes.
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Affiliation(s)
- Debra A Pinals
- Department of Psychiatry Law and Ethics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Michigan Department of Health and Human Services, Lansing, Michigan, USA
| | - Ayorkor Gaba
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Paige M Shaffer
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Michael A Andre
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - David A Smelson
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Garrod E, Jenkins E, Currie LM, McGuinness L, Bonnie K. Leveraging Nurses to Improve Care for Patients with Concurrent Disorders in Inpatient Mental Health Settings: A Scoping Review. J Dual Diagn 2020; 16:357-372. [PMID: 32320348 DOI: 10.1080/15504263.2020.1752963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: Several challenges have been identified for patients with concurrent disorders and the providers that care for them, contributing to a pressing need for interventions to improve outcomes, particularly within inpatient mental health settings. Methods: A systematic search of peer-reviewed literature was conducted using four online databases: CINAHL, MEDLINE (Ovid), PsycInfo and Web of Science. Articles were selected based on inclusion criteria and additional articles were identified through hand searches. Study details were charted and qualitative synthesis was conducted. Results: Thirty two articles met inclusion criteria. A substantial focus within the literature was education, with higher levels of education shown to improve healthcare provider attitudes and practices. Within this overarching focus, four themes were identified: 1) education as an intervention to improve attitudes and increase confidence and knowledge; 2) strategies to support practice change, including interventions aimed at clinical leaders and methods to address substance use among inpatients; 3) frameworks to guide care; and 4) opportunities to expand nursing scope of practice. Conclusions: Given the substantial evidence indicating that education improves nurses' knowledge, attitudes and practices, there is great promise in expanding educational intervention opportunities for nurses to improve care and outcomes for patients with concurrent disorders-a priority patient population.
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Affiliation(s)
- Emma Garrod
- School of Nursing, University of British Columbia, Vancouver, Canada.,Providence Health Care, Vancouver, Canada.,British Columbia Centre on Substance Use, Vancouver, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Leanne M Currie
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Liza McGuinness
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Kofi Bonnie
- Providence Health Care, Vancouver, Canada.,St. Lukes Health System, Boise, Idaho, USA
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Butler A, Love AD, Young JT, Kinner SA. Frequent Attendance to the Emergency Department after Release from Prison: a Prospective Data Linkage Study. J Behav Health Serv Res 2019; 47:544-559. [PMID: 31820327 PMCID: PMC7578130 DOI: 10.1007/s11414-019-09685-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this paper was to identify characteristics and predictors of frequent emergency department (ED) use among people released from prisons in Queensland, Australia. Baseline interview data from a sample of sentenced adults were linked to ED and hospital records. The association between baseline characteristics and frequent ED attendance was modelled by fitting multivariate logistic regression models. Participants who had ≥ 4 visits to the ED in any 365-day period of community follow-up were defined as frequent attenders (FA). The analyses included 1307 people and mean follow-up time in the community was 1063 days. After adjusting for covariates, those with a dual diagnoses of mental illness and substance use (RR = 2.42, 95% CI 1.47–3.99) and those with mental illness alone (RR = 2.47, 95% CI 1.29–4.73) were at higher risk of frequent ED attendance, compared with those with no disorder. Future research should assess whether individually tailored transition supports from prison to community reduce the frequency of ED use among this population.
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Affiliation(s)
- Amanda Butler
- Faculty of Health Sciences, Simon Fraser University, 313-1286 14th Avenue West, Vancouver, BC, V6H 1P9, Canada.
| | - Alexander D Love
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Delfin C, Krona H, Andiné P, Ryding E, Wallinius M, Hofvander B. Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data. PLoS One 2019; 14:e0217127. [PMID: 31095633 PMCID: PMC6522126 DOI: 10.1371/journal.pone.0217127] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 05/04/2019] [Indexed: 02/06/2023] Open
Abstract
One of the primary objectives in forensic psychiatry, distinguishing it from other psychiatric disciplines, is risk management. Assessments of the risk of criminal recidivism are performed on a routine basis, as a baseline for risk management for populations involved in the criminal justice system. However, the risk assessment tools available to clinical practice are limited in their ability to predict recidivism. Recently, the prospect of incorporating neuroimaging data to improve the prediction of criminal behavior has received increased attention. In this study we investigated the feasibility of including neuroimaging data in the prediction of recidivism by studying whether the inclusion of resting-state regional cerebral blood flow measurements leads to an incremental increase in predictive performance over traditional risk factors. A subsample (N = 44) from a cohort of forensic psychiatric patients who underwent single-photon emission computed tomography neuroimaging and clinical psychiatric assessment during their court-ordered forensic psychiatric investigation were included in a long-term (ten year average time at risk) follow-up. A Baseline model with eight empirically established risk factors, and an Extended model which also included resting-state regional cerebral blood flow measurements from eight brain regions were estimated using random forest classification and compared using several predictive performance metrics. Including neuroimaging data in the Extended model increased the area under the receiver operating characteristic curve (AUC) from .69 to .81, increased accuracy from .64 to .82 and increased the scaled Brier score from .08 to .25, supporting the feasibility of including neuroimaging data in the prediction of recidivism in forensic psychiatric patients. Although our results hint at potential benefits in the domain of risk assessment, several limitations and ethical challenges are discussed. Further studies with larger, carefully characterized clinical samples utilizing higher-resolution neuroimaging techniques are warranted.
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Affiliation(s)
- Carl Delfin
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - Hedvig Krona
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden
| | - Peter Andiné
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Erik Ryding
- Department of Clinical Neurophysiology, Skåne University Hospital, Lund, Sweden
| | - Märta Wallinius
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Regional Forensic Psychiatric Clinic, Växjö, Sweden
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden
| | - Björn Hofvander
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden
- Division of Forensic Psychiatry, Region Skåne, Trelleborg, Sweden
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Mårtensson S, Johansen KS, Hjorthøj C. Dual diagnosis and mechanical restraint - a register based study of 31,793 patients and 6562 episodes of mechanical restraint in the Capital region of Denmark from 2010-2014. Nord J Psychiatry 2019; 73:169-177. [PMID: 30848979 DOI: 10.1080/08039488.2019.1582695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate whether patients with dual diagnosis have a higher risk of being mechanical restraint compared to patients with only psychiatric diagnoses. METHODS Data on all patients admitted to a psychiatric ward from 2010-2014 in the Capital Region of Denmark was linked with information from the register of coercive measures. Patients were based on diagnosis divided into six groups. The three main patient groups were: only psychiatric diagnosis defined as all ICD-10 F-diagnosis except F10-F19, dual diagnosis (co-occurrence of diagnoses of harmful use or dependency and psychiatric diagnoses) and only other substance use diagnosis (i.e. other than harmful use or dependency). The risk of mechanical restraint was investigated by analyzing all first-time admissions in the period using Cox-proportional hazard models. RESULTS In the crude rates patients with dual diagnosis were more often mechanically restrained compared to patients with only psychiatric diagnoses or only other substance use diagnoses. However, this was attenuated when the characteristics of patients were accounted for. Patients with only other substance related diagnoses had the highest risk of being mechanically restrained. CONCLUSION When preventing mechanical restraint, the focus should be on actual use of substances or withdrawal effects and not on the dual diagnoses patients in them-self.
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Affiliation(s)
- Solvej Mårtensson
- a Competency Center for Dual Diagnosis, Mental Health Center Sct. Hans , Roskilde , Denmark
| | | | - Carsten Hjorthøj
- b Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital , Copenhagen , Denmark
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11
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Moore KE, Oberleitner LMS, Zonana HV, Buchanan AW, Pittman BP, Verplaetse TL, Angarita GA, Roberts W, McKee SA. Psychiatric Disorders and Crime in the US Population: Results From the National Epidemiologic Survey on Alcohol and Related Conditions Wave III. J Clin Psychiatry 2019; 80:18m12317. [PMID: 30758921 PMCID: PMC7826201 DOI: 10.4088/jcp.18m12317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/05/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Current knowledge regarding the intersection of psychiatric disorders and crime in the United States is limited to psychiatric, forensic, and youth samples. This study presents nationally representative data on the relationship of DSM-5 psychiatric disorders, comorbid substance and mental health disorders, and multimorbidity (number of disorders) with criminal behavior and justice involvement among non-institutionalized US adults. METHODS Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III (NESARC-III; 2012-2013; N = 36,309). Logistic regressions were used to examine the association of specific disorders (eg, mood, anxiety, eating, posttraumatic stress, substance use), comorbid substance use and mental health disorders, and multimorbidity with lifetime criminal behavior, incarceration experience, and past-12-month general, alcohol-related, and drug-related legal problems. RESULTS Overall, 28.5% of participants reported a history of criminal behavior, 11.4% reported a history of incarceration, 1.8% reported current general legal problems, 0.8% reported current alcohol-related legal problems, and 2.7% reported current drug-related legal problems. The presence of any disorder was associated with a 4 to 5 times increased risk of crime outcomes. Drug use disorders were associated with the highest risk of lifetime crime (adjusted odds ratio [AOR] = 6.8; 95% CI, 6.1-7.6) and incarceration (AOR = 4.7; 95% CI, 4.1-5.3) and current legal problems (AOR = 3.3; 95% CI, 2.6-4.2). Multimorbidity and comorbid substance use and mental health disorders were associated with additional risk. Controlling for antisocial personality disorder did not change the findings. CONCLUSIONS Community adults with substance use disorders, comorbid substance use and mental health disorders, and increasing multimorbidity are most at risk of crime and justice involvement, highlighting the importance of community-based addiction treatment.
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Affiliation(s)
- Kelly E Moore
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall PO Box 70649, Johnson City, TN 37614.
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Lindsay M S Oberleitner
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Howard V Zonana
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Alec W Buchanan
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Brian P Pittman
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Terril L Verplaetse
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gustavo A Angarita
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Walter Roberts
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sherry A McKee
- Department of Psychiatry, Division of Law and Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut, USA
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Zettler HR. The Impact of Dual Diagnosis on Drug Court Failure. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:357-382. [PMID: 30270702 DOI: 10.1177/0306624x18803832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is limited research investigating the relationship between dual diagnosis and drug court outcomes. The current study examines the relationship between dual diagnosis and drug court failure by specific failure type. Utilizing data from a large urban drug court in the Southwestern United States, the study finds mixed results regarding the impact of dual diagnosis on drug court failure. Specifically, while there was no evidence that dual diagnosis predicted overall success/failure, dual diagnosis significantly increased the odds of serious program failure (e.g., new offense, absconding, revocation). In contrast, dual diagnosis significantly decreased the odds of less serious failure (e.g., rule violation, relapse).
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Banks DE, Hershberger AR, Pemberton T, Clifton RL, Aalsma MC, Zapolski TCB. Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:313-322. [PMID: 30620228 DOI: 10.1080/00952990.2018.1558450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Adolescent cannabis use is associated with increased risk for psychological problems, with evidence for more severe problems among youth who use cannabis in combination with other substances (i.e., polysubstance use). Juvenile offenders engage in both cannabis use and polysubstance use at higher rates than the general adolescent population. Yet, limited research has examined the relationship between cannabis poly-use (e.g., cannabis and alcohol use) and functional or psychological problems among juvenile offenders. OBJECTIVES The current study addresses this gap by examining the association of polysubstance use of cannabis compared to cannabis only use with cognitive functioning, psychological distress, and substance-related problems among juvenile detainees. METHODS Participants were 238 detained youth ages 12-18 (80.4 % male, 77.3% non-White) who completed assessments of substance use, intellectual functioning, psychological symptoms, and substance-related problems. Youth were also assessed by a clinical psychologist for substance use disorder. RESULTS Four cannabis-use typologies were identified; cannabis and alcohol use was the largest class, followed by cannabis only use, cannabis, alcohol and other drug use, then cannabis and other drug use. Polysubstance use was associated with lower scores on measures of intellectual functioning, more externalizing and internalizing symptomology, and more substance-related problems relative to cannabis only use. However, the relationship between polysubstance use and problems varied by typology. CONCLUSIONS Findings suggest that justice-involved youth engaged in polysubstance use may be at greater need for concurrent academic, affective, and behavioral support in their rehabilitation and transition back to the community.
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Affiliation(s)
- Devin E Banks
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
| | | | - Taylor Pemberton
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
| | - Richelle L Clifton
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
| | - Matthew C Aalsma
- b Department of Pediatrics , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Tamika C B Zapolski
- a Department of Psychology , Indiana University-Purdue University , Indianapolis , IN , USA
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Boland JK, Rosenfeld B. The Role of Controlled Substance Use in Diversion Outcomes Among Mentally Ill Offenders: A Pilot Study. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:2709-2725. [PMID: 29058945 DOI: 10.1177/0306624x17735093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Diversion programs offer opportunities to offenders with substance abuse or mental illness to attend treatment as an alternative to incarceration. The present study identified variables associated with drug relapse and recidivism and the moderating role of substance use on recidivism in a diversion sample. Data were collected from 80 clients with psychotic disorders from a diversion program in New York City. Outcomes were examined after 6 and 12 months of program participation. Individuals who used controlled substances other than alcohol or cannabis were more likely to have a positive toxicology result than those who used alcohol or cannabis only or those with no alcohol/drug history. Individuals with schizoaffective disorder were more likely to be rearrested than individuals with other diagnoses, as were those with a violent offense (e.g., assault, robbery). Positive toxicology results were unrelated to rearrest and did not moderate recidivism, suggesting substance abuse may be only indirectly related to rearrest among diverted offenders.
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Peters RH, Young MS, Rojas EC, Gorey CM. Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:475-488. [PMID: 28375656 DOI: 10.1080/00952990.2017.1303838] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. OBJECTIVES To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. METHODS We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. RESULTS Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). CONCLUSION Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.
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Affiliation(s)
- Roger H Peters
- a Department of Mental Health Law and Policy , Louis de la Parte Florida Mental Health Institute, University of South Florida , Tampa , FL , USA
| | - M Scott Young
- a Department of Mental Health Law and Policy , Louis de la Parte Florida Mental Health Institute, University of South Florida , Tampa , FL , USA
| | - Elizabeth C Rojas
- b Department of Psychology , University of South Florida , Tampa , FL , USA
| | - Claire M Gorey
- b Department of Psychology , University of South Florida , Tampa , FL , USA
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Schmit EL, Schmit MK, Lenz AS. Meta-Analysis of Solution-Focused Brief Therapy for Treating Symptoms of Internalizing Disorders. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2150137815623836] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Erika L. Schmit
- Department of Psychology, Counseling, and Special Education, Texas A#x00026;M University–Commerce, Commerce, TX, USA
| | | | - A. Stephen Lenz
- Texas A#x00026;M University–Corpus Christi, Corpus Christi, TX, USA
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