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McEvoy M, Caccaviello G, Crombie A, Skinner T, Begg SJ, Faulkner P, McEvoy A, Masman K, Bamforth L, Parker C, Stanyer E, Collings A, Li X. Health and Wellbeing of Regional and Rural Australian Healthcare Workers during the COVID-19 Pandemic: Baseline Cross-Sectional Findings from the Loddon Mallee Healthcare Worker COVID-19 Study-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:649. [PMID: 38791863 PMCID: PMC11120829 DOI: 10.3390/ijerph21050649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Coronavirus 19 (COVID-19) has created complex pressures and challenges for healthcare systems worldwide; however, little is known about the impacts COVID-19 has had on regional/rural healthcare workers. The Loddon Mallee Healthcare Worker COVID-19 Study (LMHCWCS) cohort was established to explore and describe the immediate and long-term impacts of the COVID-19 pandemic on regional and rural healthcare workers. METHODS Eligible healthcare workers employed within 23 different healthcare organisations located in the Loddon Mallee region of Victoria, Australia, were included. In this cohort study, a total of 1313 participants were recruited from November 2020-May 2021. Symptoms of depression, anxiety, post-traumatic stress, and burnout were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Impact of Events Scale-6 (IES-6), and Copenhagen Burnout Inventory (CBI), respectively. Resilience and optimism were measured using the Brief Resilience Scale and Life Orientation Test-Revised (LOT-R), respectively. Subjective fear of COVID-19 was measured using the Fear of COVID-19 Scale. RESULTS These cross-sectional baseline findings demonstrate that regional/rural healthcare workers were experiencing moderate/severe depressive symptoms (n = 211, 16.1%), moderate to severe anxiety symptoms (n = 193, 14.7%), and high personal or patient/client burnout with median total scores of 46.4 (IQR = 28.6) and 25.0 (IQR = 29.2), respectively. There was a moderate degree of COVID-19-related fear. However, most participants demonstrated a normal/high degree of resilience (n = 854, 65.0%). Based on self-reporting, 15.4% had a BMI from 18.5 to 24.9 kgm2 and 37.0% have a BMI of 25 kgm2 or over. Overall, 7.3% of participants reported they were current smokers and 20.6% reported alcohol consumption that is considered moderate/high-risk drinking. Only 21.2% of the sample reported consuming four or more serves of vegetables daily and 37.8% reported consuming two or more serves of fruit daily. There were 48.0% the sample who reported having poor sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI). CONCLUSION Regional/rural healthcare workers in Victoria, Australia, were experiencing a moderate to high degree of psychological distress during the early stages of the pandemic. However, most participants demonstrated a normal/high degree of resilience. Findings will be used to inform policy options to support healthcare workers in responding to future pandemics.
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Affiliation(s)
- Mark McEvoy
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | | | - Angela Crombie
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Timothy Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Stephen J. Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Peter Faulkner
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Anne McEvoy
- Kyabram District Health Service, Kyabram, VIC 3620, Australia;
| | - Kevin Masman
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Laura Bamforth
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Carol Parker
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Evan Stanyer
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Amanda Collings
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, VIC 3550, Australia;
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Perini I, Pabst A, Martinez D, Maurage P, Heilig M. Modeling social cognition in alcohol use disorder: lessons from schizophrenia. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06601-0. [PMID: 38761256 DOI: 10.1007/s00213-024-06601-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/25/2024] [Indexed: 05/20/2024]
Abstract
A better understanding of social deficits in alcohol use disorder (AUD) has the potential to improve our understanding of the disorder. Clinical research shows that AUD is associated with interpersonal problems and the loss of a social network which impedes response to treatment. Translational research between animal models and clinical research may benefit from a discussion of the models and methods that currently guide research into social cognition in AUD. We propose that research in AUD should harness recent technological developments to improve ecological validity while maintaining experimental control. Novel methods allow us to parse naturalistic social cognition into tangible components, and to investigate previously neglected aspects of social cognition. Furthermore, to incorporate social cognition as a defining element of AUD, it is critical to clarify the timing of these social disturbances. Currently, there is limited evidence to distinguish factors that influence social cognition as a consequence of AUD, and those that precede the onset of the disorder. Both increasing the focus on operationalization of social cognition into objective components and adopting a perspective that spans the clinical spectrum will improve our understanding in humans, but also possibly increase methodological consistency and translational dialogue across species. This commentary underscores current challenges and perspectives in this area of research.
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Affiliation(s)
- Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization, Linköping, Sweden.
| | - Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Place C. Mercier 10, Louvain-la-Neuve, B-1348, Belgium
| | - Diana Martinez
- Columbia University, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Place C. Mercier 10, Louvain-la-Neuve, B-1348, Belgium
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Jeyapalan J, Sassi P, Mittendorfer Rutz E, Tiihonen J, Taipale H, Niemelä S. Characteristics of incident substance-induced psychosis compared to first-episode psychotic disorders: A nationwide register-linkage study from Sweden. Schizophr Res 2024; 264:526-533. [PMID: 38325153 DOI: 10.1016/j.schres.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Affiliation(s)
| | - Pihla Sassi
- Department of Psychiatry, University of Turku, Turku, Finland; Hospital Nova of Central Finland, Jyväskylä, Finland
| | | | - Jari Tiihonen
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Niuvanniemi Hospital, Kuopio, Finland; Neuroscience Center, University of Helsinki, Helsinki, Finland; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Heidi Taipale
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Niuvanniemi Hospital, Kuopio, Finland; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden; School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Turku, Finland; Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
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Pabst A, Gautier M, Maurage P. Hostile attributional biases in severe alcohol use disorder: replication, gender specificity, and mechanistic insights. Alcohol Alcohol 2024; 59:agae010. [PMID: 38458649 DOI: 10.1093/alcalc/agae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/10/2024] [Accepted: 02/02/2024] [Indexed: 03/10/2024] Open
Abstract
AIMS Despite their importance in the emergence and persistence of severe alcohol use disorder (SAUD), social cognition impairments remain understudied in this population. Hostile attributional biases (HAB), a key component of social cognition, may be involved in interpersonal problems and SAUD maintenance. However, current evidence for HAB in SAUD is highly preliminary, as it relies on a single study based on a small sample and on a task that cannot dissociate increased hostile from reduced benign attributions. We therefore used an improved methodology to further characterize this bias and disentangle underlying mechanisms. In addition, we explored potential gender differences. METHOD A total of 56 patients (28 women) diagnosed with SAUD and 66 (27 women) demographically matched controls completed the Word-Sentence Association Paradigm-Hostility, which provides a valid, spontaneous, and relatively implicit assessment of both hostile and benign social attributions related to ambiguous situations. They also completed self-report measures of psychopathology and interpersonal problems. RESULTS At the group-level, patients with SAUD presented higher HAB than controls, without group differences for benign attributions. Gender analyses revealed that this effect selectively emerged in men with SAUD. Further, patients' benign attributions did not differ from their hostile attributions. Finally, HAB (not benign attributions) were associated with interpersonal problems and state anxiety in patients. CONCLUSIONS The association between SAUD and HAB at the group level is genuine and replicable across samples and tasks. This association may further selectively emerge in men. Our results also confirm the functional significance of HAB in SAUD, and point to potential mechanisms and clinical recommendations.
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Affiliation(s)
- Arthur Pabst
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, B-1348 Louvain-la-Neuve, Belgium
| | - Mado Gautier
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, B-1348 Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, B-1348 Louvain-la-Neuve, Belgium
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Riedl D, Labek K, Gstrein I, Rothmund MS, Sperner-Unterweger B, Kantner-Rumplmair W. Large improvement of mental health during in outpatient short-term group psychotherapy treatment-a naturalistic pre-/post-observational study. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023; 37:57-64. [PMID: 36480103 DOI: 10.1007/s40211-022-00449-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/05/2022] [Indexed: 06/03/2023]
Abstract
BACKGROUND Group psychotherapy is an effective treatment for patients with mental health issues. This study aims to evaluate data on the effectiveness of a cost-free short-term outpatient group psychotherapy project for patients with mixed mental health issues in Tyrol, Austria. METHODS In this naturalistic observational study, outpatients taking part in the psychotherapeutic group treatment between spring 2018 and spring 2020 were included. Patients completed the patient health questionnaire (PHQ-D), an item of the working ability index (WAI) and single items on symptom burden, treatment expectation and perceived benefit before the first (T0) and/or last group session (T1). Mean changes were investigated using repeated measure analyses of variance (rANOVA). RESULTS A total of 98 patients were included in the study. Statistically significant improvements with medium to large effect sizes were observed for depression (η2 = 0.22, p < 0.001), somatization (η2 = 0.10, p = 0.008), anxiety (η2 = 0.18, p < 0.001), and subjective working ability (η2 = 0.22, p < 0.001). Neither age (p = 0.85), sex (p = 0.34), baseline symptoms (p = 0.29-0.77), nor previous experience with individual (p = 0.15) or group psychotherapy (p = 0.29) were associated with treatment outcome. However, treatment expectation at baseline was significantly associated with the patients' perception of the treatment benefit (r = 0.39, p < 0.001). CONCLUSION Our study highlights the benefit of outpatient short-term group psychotherapy for individuals with mental health issues. Group psychotherapy should be offered free of charge to individuals with mental health issues by social health providers.
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Affiliation(s)
- David Riedl
- University Clinic of Psychiatry II, Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria.
| | - Karin Labek
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Ines Gstrein
- Tyrolean Regional Association of Psychotherapy, Innsbruck, Austria
| | - Maria-Sophie Rothmund
- University Clinic of Psychiatry II, Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Clinic of Psychiatry II, Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Wilhelm Kantner-Rumplmair
- University Clinic of Psychiatry II, Department of Psychiatry, Psychotherapy Psychosomatics and Medical Psychology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
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Pabst A, Bollen Z, Masson N, Billaux P, de Timary P, Maurage P. An eye-tracking study of biased attentional processing of emotional faces in severe alcohol use disorder. J Affect Disord 2023; 323:778-787. [PMID: 36529408 DOI: 10.1016/j.jad.2022.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/07/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Social cognition impairments in severe alcohol use disorder (SAUD) are increasingly established. However, fundamental aspects of social cognition, and notably the attentional processing of socio-affective information, remain unexplored, limiting our understanding of underlying mechanisms. Here, we determined whether patients with SAUD show attentional biases to specific socio-affective cues, namely emotional faces. METHOD In a modified dot-probe paradigm, 30 patients with SAUD and 30 demographically matched healthy controls (HC) were presented with pairs of neutral-emotional (angry, disgusted, happy, sad) faces while having their eye movements recorded. Indices of early/automatic (first fixations, latency to first fixations) and later/controlled (number of fixations, dwell-time) processes were computed. RESULTS Patients with SAUD did not differ from HC in their attention to angry/disgusted/sad vs. neutral faces. However, patients with SAUD fixated/dwelled less on happy vs. neutral faces in the first block of stimuli than HC, who presented an attentional bias to happy faces. LIMITATIONS Sample-size was determined to detect medium-to-large effects and subtler ones may have been missed. Further, our cross-sectional design provides no explanation as to whether the evidenced biases precede or are a consequence of SAUD. CONCLUSIONS These results extend the social cognition literature in SAUD to the attentional domain, by evidencing the absence of a controlled attentional bias toward positive social cues in SAUD. This may reflect reduced sensitivity to social reward and could contribute to higher order social cognition difficulties and social dysfunction.
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Affiliation(s)
- Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Zoé Bollen
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nicolas Masson
- Numerical Cognition Group, Psychological Sciences Research Institute and Neuroscience Institute, UCLouvain, Louvain-la-Neuve, Belgium; Cognitive Science and Assessment Institute, University of Luxembourg, Luxembourg
| | - Pauline Billaux
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Philippe de Timary
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, Saint-Luc Academic Hospital & Institute of Neuroscience, UCLouvain, Brussels, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
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Armoon B, Fleury MJ, Bayat AH, Bayani A, Mohammadi R, Griffiths MD. Quality of life and its correlated factors among patients with substance use disorders: a systematic review and meta-analysis. Arch Public Health 2022; 80:179. [PMID: 35927697 PMCID: PMC9351239 DOI: 10.1186/s13690-022-00940-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Patients with substance use disorder (SUD) usually report lower quality of life (QoL) than other patients and as much as patients with other mental disorders. The present study investigated variables associated with QoL domains among patients with SUD. Methods Studies in English published before December 1st 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on factors associated with QoL domains among patients with SUD. After reviewing for study duplicates, the full-texts of selected papers were assessed for eligibility using PECO (Participants, Exposures, Comparison and Outcome) criteria: (a) participants: patients with SUD; (b) exposures: sociodemographic factors, clinical, and service use variables; (c) comparison: patient groups without SUD; and (d) outcomes: four domains of QoL (physical, mental, social, and environmental domains). Three researchers recorded the data independently using predefined Excel spreadsheets. The Newcastle–Ottawa Scale (NOS) was used for assessing risk of bias and rated each study in terms of exposure, outcome, and comparability. Pooled odds ratios (ORs) and β coefficient were utilized at a 95% confidence level, and because sampling methods differed between studies’ pooled estimates, a random effects model was utilized. Results After the assessment of over 10,230 papers, a total of 17 studies met the eligibility criteria. Five studies (1260 participants) found that patients with SUD who were older were less likely to have a good physical Qol (OR = 0.86, 95% CI = 0.78, 0.95). Two studies (1171 participants) indicated that patients with SUD who were homeless were less likely to have a good environmental Qol (β = -0.47, p = 0.003). However, a better mental QoL was observed in four studies (1126 participants) among those receiving support from their family or friends (social networks) (OR = 1.05, 95% CI = 1.04, 1.07). Two studies (588 participants) showed that those using cocaine were less likely to have a good mental QoL (OR = 0.83, 95% CI = 0.75, 0.93). Two studies (22,534 participants) showed that those using alcohol were less likely to have a good physical QoL (β = -2.21, p = 0.001). Two studies (956 participants) showed that those having severe substance use disorders were less likely to have a good mental (β = -5.44, p = 0.002) and environmental (β = -0.59, p = 0.006) QoL respectively. Four studies (3515 participants) showed that those having mental disorders were less likely to have a good physical QoL (β = -1.05, p = 0.001), and another three studies (1211 participants) that those having mental disorders were less likely to have a good mental QoL (β = -0.33, p = 0.001). Finally, two studies (609 and 682 participants) showed that individuals who experienced trauma symptoms or mental disorders were less likely to have good social and environmental QoL, respectively (OR = 0.78, 95% CI = 0.61, 1.00) and (OR = 0.92, 95% CI = 0.9, 0.94). Conclusions The findings suggest the need for mental health services to improve the QOL among patients with SUD but further study is needed. Cocaine may cause behavioral changes which can increase the possibility of reckless and suicidal behaviors. Therefore, identifying cocaine user access, adherence, and satisfaction with treatment is recommended as an important component of adaptive functioning. Interventions that help patients with SUD get support from people within their social networks who support their recovery are also essential to their QoL. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00940-0.
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Christiansen SG, Moan IS. Employment trajectories among those treated for alcohol use disorder: A register-based cohort study. Addiction 2022; 117:913-924. [PMID: 34697851 DOI: 10.1111/add.15726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/30/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Employment during and following treatment for alcohol use disorder (AUD) is important for the individual's health and well-being and for reducing the societal costs associated with benefit payments. Nonetheless, this is an under-researched topic. This study aimed to identify trajectories of labour force participation among people enrolled in AUD treatment and describe the characteristics of those following contrasting pathways. DESIGN Using trajectory analysis, we modelled employment trajectory groups among AUD patients during the year of treatment entry and the 4 subsequent years, applying Norwegian longitudinal register data. SETTING Norway. PARTICIPANTS Patients who entered treatment with AUD as the primary diagnosis during 2009 and 2010 (9000 patients, age 20-61 years). MEASUREMENTS The outcome variable 'labour force attachment' was measured as being in full-time employment, partly employed, on temporary welfare benefits or on permanent disability pension. Predictors were age, gender, education and comorbid mental health and drug use disorders. FINDINGS We distinguished six employment trajectories among AUD patients: 15.8% were on permanent disability pension throughout, 8.7% exited the labour force on permanent disability pension during the observation period, 32.1% had a medium attachment throughout follow-up, and 9.2% had a decreasing attachment; 23.3% had a high labour force attachment throughout, and 10.9% experienced increasing attachment. High attachment throughout was negatively associated with being female (P < 0.001), having lower educational attainment (P < 0.001), and having comorbid mental health (P < 0.001) and drug use disorders (P < 0.001). CONCLUSIONS Norwegian patients treated for alcohol use disorder in 2009 and 2010 followed six employment trajectories during the 5 years following treatment entry and had lower labour force participation than the general population. Nearly a quarter had a high labour force attachment throughout treatment, which was positively associated with being male, having higher educational attainment and having fewer comorbid mental health and drug use disorders.
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Affiliation(s)
| | - Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Predictors of Short-Term Alcohol Drinking in Patients with Alcohol Use Disorders during the Third Wave of the COVID-19 Pandemic: Prospective Study in Three Addiction Outpatient Centers in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041948. [PMID: 35206137 PMCID: PMC8872315 DOI: 10.3390/ijerph19041948] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/27/2022] [Accepted: 01/30/2022] [Indexed: 12/12/2022]
Abstract
The present study investigates the extent to which the COVID-19 crisis disturbed different life domains of patients with alcohol use disorder (AUD) and assessed the associations between these disturbances and the risk of short-term alcohol drinking. All patients aged >18 years receiving outpatient care at three addiction treatment facilities from 15 April to 30 May 2021 were eligible for inclusion in the study. A trained resident assessed the extent to which the COVID-19 crisis affected their professional activity, social life, access to healthcare, and drinking problems, together with craving, drinking behavior, psychological distress, physical/mental health, and sociodemographic and clinical data. The same investigator assessed alcohol drinking 1 month after their visit. Nearly half of the patients felt that the COVID-19 crisis had a serious impact on their drinking problems, despite minor disruptions in access to healthcare. These disturbances significantly influenced short-term alcohol drinking in univariate analysis, together with psychological distress, craving, and drinking problems. Only craving predicted alcohol drinking in multivariate analyses, suggesting that psychological and drinking problems, as well as COVID-19 disturbances, increased the risk of alcohol drinking by increasing craving. Craving should be systematically investigated in patients with AUD to establish adapted social support systems during pandemics.
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Buchholz A, Berner M, Dams J, Rosahl A, Hempleman J, König HH, Konnopka A, Kriston L, Piontek D, Reimer J, Röhrig J, Scherbaum N, Silkens A, Kraus L. Patient-centered placement matching of alcohol-dependent patients based on a standardized intake assessment: process evaluation within an exploratory randomized controlled trial. BMC Psychiatry 2022; 22:60. [PMID: 35086501 PMCID: PMC8793210 DOI: 10.1186/s12888-022-03705-9] [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: 05/31/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the implementation of placement matching guidelines, feasibility has been concerned in previous research. Objectives of this process evaluation were to investigate whether the patient-centered matching guidelines (PCPM) are consistently applied in referral decision-making from an inpatient qualified withdrawal program to a level of care in aftercare, which factors affect whether patients actually receive matched aftercare according to PCPM, and whether its use is feasible and accepted by clinic staff. METHODS The study was conducted as process evaluation within an exploratory randomized controlled trial in four German psychiatric clinics offering a 7-to-21 day qualified withdrawal program for patients suffering from alcohol dependence, and with measurements taken during detoxification treatment and six months after the initial assessment. PCPM were used with patients in the intervention group by feeding back to them a recommendation for a level of care in aftercare that had been calculated from Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff on the treatment unit. As measurements, The MATE, the Client Socio-Demographic and Service Receipt Inventory-European Version, a documentation form, the Control Preference Scale, and the Motivation for Treatment Scale were administered. A workshop for the staff at the participating trial sites was conducted after data collection was finished. RESULTS Among 250 patients participating in the study, 165 were interviewed at follow-up, and 125 had received aftercare. Although consistency in the application of PCPM was moderate to substantial within the qualified withdrawal program (Cohen's kappa ≥ .41), it was fair from discharge to follow-up. In multifactorial multinomial regression, the number of foregoing substance abuse treatments predicted whether patients received more likely undermatched (Odds Ratio=1.27; p=.018) or overmatched (Odds Ratio=0.78; p=.054) treatment. While the implementation process during the study was evaluated critically by the staff, they stated a potential of quality assurance, more transparency and patient-centeredness in the use of PCPM. CONCLUSIONS While the use of PCPM has the potential to enhance the quality of referral decision making within treatment, it may not be sufficient to determine referral decisions for aftercare. TRIAL REGISTRATION German Clinical Trials Register DRKS00005035 . Registered 03/06/2013.
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Affiliation(s)
- Angela Buchholz
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre of Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | - Michael Berner
- Municipal Clinical Center of Karlsruhe, Karlsruhe, Germany
| | - Judith Dams
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Rosahl
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre of Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Jochen Hempleman
- Outpatient Department for Addiction, LWL-Hospital Muenster, Muenster, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre of Hamburg-Eppendorf, 20246, Hamburg, Germany
| | | | - Jens Reimer
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
- Centre for Psychosocial Medicine, Health North, Bremen, Germany
| | - Jeanette Röhrig
- Clinic for Addiction Medicine and Addictive Behaviour, Institute for Clinical Psychology, Klinikum Stuttgart, Stuttgart, Germany
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Addictive Behavior and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Duisburg, Germany
| | - Anna Silkens
- LVR-Hospital Essen, Department of Addictive Behavior and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Duisburg, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, München, Germany
- Department for Public Health Sciences, Stockholm University, Stockholm, Sweden
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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11
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Social perception and knowledge impairments in severe alcohol use disorder: Group and individual-level findings. Drug Alcohol Depend 2021; 227:109009. [PMID: 34482036 DOI: 10.1016/j.drugalcdep.2021.109009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Consistent data highlight the presence and clinical significance of social cognition impairments in severe alcohol use disorder (SAUD). However, social perception and knowledge (i.e., the ability to interpret social situations and to identify latent social rules), an important social cognition component, has not yet been explored in this disorder. METHOD 35 patients with SAUD and 35 healthy controls (HC) completed the Social Perception and Knowledge test (PerSo), an experimental task requiring participants to comprehensively describe social situations and to identify the social rules illustrated in 8 pictures. We performed group and single-case analyses. RESULTS Patients with SAUD, as a group, spontaneously identified less relevant "where"/"who"/"what" aspects of the social situations (social perception) than HC. They were however able to provide these elements when explicitly asked to. They were also less able to identify the social rules that subtended the situations (social knowledge). Single-case analyses revealed that 23 % of patients were significantly impaired for social perception, and 34 % for social knowledge. DISCUSSION We provide novel evidence that SAUD is associated with social perception and knowledge impairments at the group level, and that these impairments strongly vary across patients. Such results should lead to the integration of social perception and knowledge impairments in the conceptualization and treatment of socio-affective difficulties in SAUD.
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12
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Gautier M, Pabst A, Maurage P. Social decision making in severe alcohol use disorder: Scoping review and experimental perspectives. Alcohol Clin Exp Res 2021; 45:1548-1559. [PMID: 34342010 DOI: 10.1111/acer.14664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/21/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with severe alcohol use disorder (SAUD) demonstrate multifaceted impairments in social cognition abilities, including emotional decoding or Theory of Mind. Such impairments are associated with real-life interpersonal difficulties, which in turn could contribute to the persistence of SAUD. However, little is known regarding how patients with SAUD make decisions in a social context and this literature has not been comprehensively reviewed. OBJECTIVES The main aim of this paper was to conduct the first review specifically focusing on social decision-making abilities in SAUD. Following PRISMA guidelines for scoping reviews, we describe existing knowledge regarding the difficulties experienced by patients with SAUD during social interactions. Our second objective was to propose perspectives for future research, based on the shortcomings identified in the available literature. DESIGN We searched three online databases (PubMed, PsycINFO, and Scopus) and identified 14 papers using behavioral tasks to assess social decision making in patients with SAUD. RESULTS Included studies assessed social decision making through three paradigms: (1) economic games (four papers), (2) moral dilemmas (four papers), and (3) interpersonal problem-solving (six papers). Results indicated that patients with SAUD behave differently from controls in all three paradigms. CONCLUSIONS Previous studies suggested large-scale social decision-making impairments or biases in SAUD. However, in light of the limited number of studies available and of the restricted set of processes measured, we call for the extension of this field through more ecologically relevant and model-based paradigms in order to elucidate the underlying mechanisms of these effects.
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Affiliation(s)
- Mado Gautier
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Arthur Pabst
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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13
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Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders. Addict Sci Clin Pract 2021; 16:44. [PMID: 34193283 PMCID: PMC8246687 DOI: 10.1186/s13722-021-00252-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose Support from family and other social network elements can be important in helping patients to cope with practical and emotional consequences of diseases. The aim of the study was to examine perception of family and social support and quality of life (QoL) in patients undergoing treatment for substance use disorders (SUDs). We compared them with patients in treatment for mental disorders (MDs) and physical disorders (PDs). Methods We used data from a national multicenter study that recruited patients (N = 518) from three treatment domains; SUD treatment units, MD treatment units, and PD treatment units (severe neurological conditions or cancer). Data on family cohesion, social support, and QoL were compared across patient groups. In addition, data on health variables was collected. We used a multiple linear regression procedure to examine how health and support variables were associated with QoL. Results Family cohesion and social support in the SUD and MD groups were rated at similarly low levels, substantially lower than in the PD group. The SUD group exhibited a somewhat lower QoL than did the PD group, but their QoL was still in the near-to-normal range. In contrast, the MD group had markedly low QoL. When examining factors associated with QoL, we found that greater family cohesion and social support were positively associated with QoL. Mental distress was the strongest factor, and was negatively associated with QoL (beta − 0.15, 95% CI = − 0.17/− 0.14, p < 0.001). Conclusion Service providers need to be aware of the weaker networks and less regulatory family and/or social support available to patients with SUDs. Providers should focus consistently on the social networks of patients and include patients’ families in treatment processes.
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14
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Constant A, Sanz M, Auffret M, Naudet F, Vérin M, Moirand R. French Validation of the Alcohol Urge Questionnaire: Psychometric Properties and Relationship with Alcohol Dependence and Drinking Behavior. Alcohol Alcohol 2021; 56:251-257. [PMID: 33089320 DOI: 10.1093/alcalc/agaa103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 11/14/2022] Open
Abstract
AIM To validate a French translation of the Alcohol Urge Questionnaire (AUQ) that measures craving in patients with alcohol dependence. METHOD All patients aged > 18 years who were hospitalized for alcohol detoxification from February to May 2019 in the alcohol unit of the Rennes university hospital were eligible. A back-translated version of the AUQ was completed at admission. Patients were interviewed at the end of the 7-day detoxification program by a trained addiction psychiatrist (MS), using tablet computed-based questionnaires assessing state craving (visual analog scale), alcohol dependence severity, drinking behavior, psychological distress and physical/mental health. The same investigator assessed relapse 1 month after discharge. RESULTS A total of 80 inpatients were recruited and completed questionnaires. The single factor structure of the French version of the AUQ was similar to the original questionnaire, and was supported by strong internal reliability and item-scale validity. The AUQ score correlated highly acute craving measure, but moderately scales assessing the severity of alcohol dependence, drinking behavior and mental health. Relapse 1 month after discharge was significantly related to AUQ score assessed either at baseline, or with better estimate at the end of the 7-day detoxification period. CONCLUSION The French version of the AUQ provides a reliable measure of phasic craving, which is best described as a context-dependent single-factor variable, related to but distinct from tonic craving, dependence severity and drinking behavior. The ease of administration makes the AUQ a useful tool for French-speaking patients with alcohol dependence.
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Affiliation(s)
- Aymery Constant
- INRAE, INSERM, Univ Rennes1, Nutrition Metabolisms and Cancer Institute, NuMeCan, Rennes, France.,EHESP School of Public Health, F-35043 Rennes, France
| | - Marlene Sanz
- CHU de Rennes, Unité d'Addictologie, F-35033 Rennes, France
| | - Manon Auffret
- Behavior & Basal Ganglia Research Unit (EA 4712), University of Rennes 1, F-35700 Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), F-35700 Rennes, France
| | - Florian Naudet
- INRAE, INSERM, Univ Rennes1, Nutrition Metabolisms and Cancer Institute, NuMeCan, Rennes, France
| | - Marc Vérin
- Behavior & Basal Ganglia Research Unit (EA 4712), University of Rennes 1, F-35700 Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), F-35700 Rennes, France.,Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, F-35033 Rennes, France
| | - Romain Moirand
- INRAE, INSERM, Univ Rennes1, Nutrition Metabolisms and Cancer Institute, NuMeCan, Rennes, France.,CHU de Rennes, Unité d'Addictologie, F-35033 Rennes, France
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15
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Maurage P, Pabst A, Lannoy S, D'Hondt F, de Timary P, Gaudelus B, Peyroux E. Tackling heterogeneity: Individual variability of emotion decoding deficits in severe alcohol use disorder. J Affect Disord 2021; 279:299-307. [PMID: 33096328 PMCID: PMC7738413 DOI: 10.1016/j.jad.2020.10.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/02/2020] [Accepted: 10/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Severe alcohol use disorder (SAUD) is associated with social cognition deficits. Patients with SAUD are impaired for the recognition of emotional facial expressions, particularly at early stages of abstinence. These deficits damage interpersonal relations and increase relapse risk. However, uncertainties still abound on their variation across emotions and on the heterogeneity of emotional impairments across patients. We addressed these questions by exploring how the deficit varies according to emotions' type/intensity and patients' heterogeneity. METHODS Sixty-five recently detoxified patients with SAUD and 65 matched healthy controls performed the Facial Emotion Recognition Test, assessing the ability to identify six emotions (anger, contempt, disgust, fear, happiness, sadness) displayed by morphed faces with various intensities. Accuracy scores and detection thresholds were collected for each emotion. Beyond group comparisons, multiple single-case analyses determined the percentage of patients presenting decoding deficits for each emotion. RESULTS When current depression and anxiety symptoms were controlled for, patients did not present a general emotion decoding deficit, but were rather characterized by specific deficits for disgust/contempt in accuracy, and for disgust in detection threshold scores. Single-case analyses showed that only a third of patients presented a clinically significant emotional deficit. CONCLUSIONS Patients with SAUD only present emotional decoding deficits for specific interpersonal emotions (disgust/contempt) when subclinical psychopathological states are controlled for, and show no general emotional impairment. This goes against the proposal of a generalized social cognition deficit in this population. This group effect moreover masks a massive heterogeneity across patients, which has implications at experimental and clinical levels.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Séverine Lannoy
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; CHU Lille, Clinique de Psychiatrie, CURE, Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Philippe de Timary
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, Saint-Luc Academic Hospital & Institute of Neuroscience, UCLouvain, Brussels, Belgium
| | - Baptiste Gaudelus
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Lyon, France
| | - Elodie Peyroux
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Lyon, France
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16
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Huỳnh C, Kisely S, Rochette L, Pelletier É, Jutras-Aswad D, Larocque A, Fleury MJ, Lesage A. Using administrative health data to estimate prevalence and mortality rates of alcohol and other substance-related disorders for surveillance purposes. Drug Alcohol Rev 2021; 40:662-672. [PMID: 33432695 DOI: 10.1111/dar.13235] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Administrative health databases (AHD) are critical to guide health service management and can inform the whole spectrum of substance-related disorders (SRD). This study estimates prevalence and mortality rates of SRD in administrative health databases. METHODS The Quebec Integrated Chronic Disease Surveillance System consists of linked AHD. Analyses were performed on data of all Quebec residents aged 12 and over and eligible for health-care coverage using the International Classification of Diseases (ninth or tenth revision) for case identification. Mortality rate ratios stratified by causes of death were obtained to calculate an excess of mortality. RESULTS Since 2001-2002, the annual age-adjusted prevalence rate of diagnosed overall SRD remained stable (8.6 per 1000 in 2017-2018). In any given year, the annual prevalence rate was significantly higher in males; adolescents had the lowest rate, while adults 65 years and older the highest. The annual 2017-2018 rate was 2.1 per 1000 for alcohol-induced disorder, 1.9 for other drug-induced disorder, 0.7 for alcohol intoxication and 0.6 for other drug intoxications. Cumulative rate of any diagnosis related to alcohol was 32 per 1000 females and 53 per 1000 males (2001-2018), and 33 per 1000 females and 49 per 1000 males for any diagnosis related to other drugs. There was an excess of all-cause mortality among individuals with SRD compared to the general population. DISCUSSION AND CONCLUSIONS AHD can complement epidemiological surveys in monitoring SRD jurisdiction-wide. Surveillance of services utilisation and interventions, coupled with health outcomes like mortality, could be useful in guiding health services planning.
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Affiliation(s)
- Christophe Huỳnh
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal (Integrated University Centre of Health and Social Services of the Centre-South-of-the-Island-of-Montréal), Montreal, Canada.,Department of Psychiatry and Addiction, University of Montréal, Montreal, Canada.,School of Psychoeducation, University of Montreal, Montreal, Canada.,Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada
| | - Steve Kisely
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Louis Rochette
- Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada
| | - Éric Pelletier
- Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada
| | - Didier Jutras-Aswad
- University Institute on Addictions, CIUSSS du Centre-Sud-de-l'Île-de-Montréal (Integrated University Centre of Health and Social Services of the Centre-South-of-the-Island-of-Montréal), Montreal, Canada.,Department of Psychiatry and Addiction, University of Montréal, Montreal, Canada.,Research Centre, Centre Hospitalier de l'Université de Montréal (University of Montreal Health Centre), Montreal, Canada
| | - Alexandre Larocque
- Department of Emergency Medicine, Centre Hospitalier de l'Université de Montréal (University of Montreal Health Centre), Montreal, Canada.,Quebec Poison Control Center, Québec City, Canada
| | | | - Alain Lesage
- Department of Psychiatry and Addiction, University of Montréal, Montreal, Canada.,Bureau d'information et d'études en santé des populations (Bureau of Information and Studies on the Health of Populations), Institut National de Santé Publique du Québec (National Institute of Public Health of Quebec), Quebec City, Canada.,Research Centre of the Montreal Mental Health University Institute, Montreal, Canada
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17
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Grunze H, Schaefer M, Scherk H, Born C, Preuss UW. Comorbid Bipolar and Alcohol Use Disorder-A Therapeutic Challenge. Front Psychiatry 2021; 12:660432. [PMID: 33833701 PMCID: PMC8021702 DOI: 10.3389/fpsyt.2021.660432] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/01/2021] [Indexed: 02/05/2023] Open
Abstract
Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40-70%, both for Bipolar I and II disorder, and with male preponderance. Alcohol use disorder and bipolarity significantly influence each other's severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity.
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Affiliation(s)
- Heinz Grunze
- Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Germany
- Paracelsus Medical University Nuremberg, Nuremberg, Germany
- *Correspondence: Heinz Grunze
| | - Martin Schaefer
- Klinik für Psychiatrie, Psychotherapie, Psychosomatik, und Suchtmedizin, Evang. Kliniken Essen-Mitte, Essen, Germany
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Christoph Born
- Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Germany
- Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Ulrich W. Preuss
- Vitos Klinik Psychiatrie und Psychotherapie, Herborn, Germany
- Klinik für Psychiatrie, Psychotherapie, und Psychosomatik, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
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Spies M, Meyer-Steinkamp R, Stracke R, Buchholz A. Development of a modular ICF-based core set for the German substance use disorders treatment. Disabil Rehabil 2020; 44:1234-1242. [PMID: 32723115 DOI: 10.1080/09638288.2020.1799246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE We aimed to develop a modular Core Set based on the International Classification of Functioning, Disability and Health (ICF) for describing functioning in patients with substance use disorders (SUDs). To match the structure of the German health service system, the Core Set was split into modules for different service segments. METHODS We followed a consensus process including several preparatory studies. To identify candidate ICF categories, we performed an ICF linking of guideline-recommended assessments, patient focus groups and patient and expert surveys. Categories were prioritized for different service segments and compiled into preliminary modules. The Core Set was tested in 13 treatment sites. Health professionals rated each category's relevance, and contents of the Modular ICF-based Core Set for SUDs (MCSS) were compared to patient-reported treatment goals. An advisory board decided on revisions to the MCSS. RESULTS The MCSS consists of a basic module (25 categories) and five additional modules for these treatment segments: counselling (8), qualified withdrawal (6), orientation (7), rehabilitation (32), and social integration services (10). CONCLUSIONS The MCSS provides a framework for harmonizing communication, documentation and interface management in German SUD health services. The basic module, consisting of 25 categories, can be employed as a Brief ICF Core Set.Implications for rehabilitationThe MCSS can serve as a standard for describing functioning in patients with SUDs in Germany, as well as harmonize communication and reporting of treatment relevant information.In clinical practice, the MCSS can be used for the structured assessment of psychosocial problems and participation restrictions, goal setting, and outcome evaluation.Although the MCSS was developed in Germany, its proximity to the themes frequently identified in the literature regarding SUDs internationally suggests that it may be of use in other countries as well.The basic module may be employed as a Brief ICF Core Set.
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Affiliation(s)
- M Spies
- Department for Medical Psychology, University Medical Centre, Hamburg, Germany
| | | | - R Stracke
- Alida Schmidt-Stiftung, Hamburg, Germany
| | - A Buchholz
- Department for Medical Psychology, University Medical Centre, Hamburg, Germany
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20
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Construction and Validation of the Inventory of Addiction Awareness (ICE-A). Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00137-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Constant A, Val-Laillet D, Joubert A, Foret K, Thibault R, Moirand R. Depressive symptoms are related to boredom proneness in patients receiving hospital care, regardless of alcohol status, lifestyle, or social support. J Health Psychol 2019; 26:1674-1683. [DOI: 10.1177/1359105319886049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We examined the relationship between boredom proneness and psychological distress in patients receiving hospital care due either to excessive alcohol consumption or to gastrointestinal diseases. Sociodemographic data were collected together with boredom proneness subscales (internal/external lack of stimulation), psychological distress, physical activity, and social support. Boredom proneness due to a lack of external stimulation seemed to constitute a prominent personality trait in patients with alcohol consumption. But depressive symptoms were related only to boredom proneness due to a lack of internal stimulation in all patients, regardless of alcohol status, lifestyle, or social support. Potential implications for practice and future research are discussed.
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Affiliation(s)
- Aymery Constant
- Nutrition Metabolisms and Cancer (NuMeCan), France
- Ecoles des Hautes Etudes en Santé Publique (EHESP), France
| | | | | | | | - Ronan Thibault
- Nutrition Metabolisms and Cancer (NuMeCan), France
- CHU de Rennes, France
| | - Romain Moirand
- Nutrition Metabolisms and Cancer (NuMeCan), France
- CHU de Rennes, France
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22
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Ates N, Unubol B, Bestepe EE, Bilici R. The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder. J Ethn Subst Abuse 2019; 22:316-336. [PMID: 31686619 DOI: 10.1080/15332640.2019.1685051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of perceived social support on the quality of life of male patients with alcohol, opiate and synthetic cannabinoid use disorders by considering sociodemographic factors and mood, and to compare these three groups in terms of social support and quality of life. METHOD One hundred and thirtyone (131) patients who were hospitalized at Addiction Clinic of Istanbul Erenkoy Psychiatric and Neurological Diseases Training and Research Hospital in Turkey and diagnosed as alcohol, opiate and synthetic cannabinoid use disorder were included in the study. Sociodemographic Data Form, Turkish version of the World Health Organization Quality of Life Questionnaire Scale (WHOQOL-BREF-TR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), API (Addiction Profile Index) were applied to the participants. RESULTS A total of 131 male patients were 32 synthetic cannabinoids, 51 opiates and 48 alcohol use disorders diagnosed. The mean age of alcohol users was higher than the other groups. Separation/divorce rate was higher in alcohol users and single rate in opiate users. Alcohol use was higher in living alone and opiate users lived with first degree relatives. The crime history was higher in the cannabis group. Prison experience, probation and self-injury were higher among opiate users. Family history of substance use was higher in opiate users. Crime was found to be less in alcohol users. In the comparison of alcohol and substance (opiate, cannabis) groups, the rate of self-injury (93.8%) was found to be significantly higher in the substance user' group. There was no statistically significant difference between the groups in terms of depression and anxiety scores. When the alcohol and substance (opiate, cannabis) comparisons were made between the groups, the mean depression (21.02 ± 11.6) and anxiety (20.09 ± 17.49) of the alcohol group was significantly higher. The "effect on life" (31.8 ± 6.13) and "motivation" subscales (10.38 ± 2.39) of API was found to be significantly higher in patients with substance use. In the opioid group, physical, environmental and psychological subscales of the WHOQOL-BREF-TR did not show significant correlation with MSPSS, and the family, friend' subscales and total perceived social support were significantly correlated with the social subscale of WHOQOL-BREF-TR. In the alcohol group, the environmental and social subscales of WHOQOL-BREF-TR showed a significant correlation with perceived social support from the family and private person and total perceived support. CONCLUSION Addiction is a recurrent and chronic disease and inevitably reduces quality of life. Social support has an important role on the quality of life. Improving the quality of life seems to be one of the main goals during the addiction treatment. For this purpose, it is very important to provide psychosocial support with pharmacological treatment by evaluating the medical, mental and social needs of the dependent patient as a whole.
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Affiliation(s)
- Nazli Ates
- Darica Farabi Training and Research Hospital, Kocaeli, Turkey
| | - Basak Unubol
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Engin Emrem Bestepe
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Rabia Bilici
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
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Levola J, Eskelinen S, Pitkänen T. Associations between self-rated health, quality of life and symptoms of depression among Finnish inpatients with alcohol and substance use disorders. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1664667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jonna Levola
- HUS Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saana Eskelinen
- HUS Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Cabello M, de la Fuente J, Ayuso Mateos JL, Pitkänen T. Longitudinal properties of the PARADISE24fin questionnaire in treatment of substance use disorders. Addict Behav 2019; 95:125-128. [PMID: 30904776 DOI: 10.1016/j.addbeh.2019.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/17/2019] [Accepted: 03/17/2019] [Indexed: 12/16/2022]
Abstract
AIM Improvement of overall functioning is an important goal in the treatment of substance use disorders, and thus tools for monitoring change are needed. The current study aimed to evaluate the longitudinal metric invariance and sensitivity to change for the PARADISE24fin questionnaire. METHODS A total of 1153 patients with substance use disorders completed the PARADISE24fin in two measurement occasions along their treatment. Patients were categorized into three groups according to their treatment status at the second occasion (end of the treatment, on-treatment follow-up, and re-start treatment). The latent structure of the PARADISE24fin questionnaire was analyzed in the two measurement occasions with confirmatory factor analyses. Evidence of the PARADISE24fin sensitivity to change was studied comparing mean change scores for the three treatment status groups. RESULTS The PARADISE24fin showed a strong longitudinal metric invariance across the two occasions in the three treatment status groups. The PARADISE24fin scores decreased during treatment, especially among the group of patients that had completed their treatment. CONCLUSIONS The PARADISE24fin is a reliable questionnaire to measure changes in psychosocial difficulties in substance use disorders overtime.
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Ekmekci Ertek I, Taner ME, Nazik Yüksel R, Ozan Kotan V, Göka E. Quality of life and pain perception in alcohol dependence: A comparative examination of patients, their relatives, and healthy controls. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1612473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Irem Ekmekci Ertek
- Department of Psychiatry, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Ender Taner
- Department of Psychiatry, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Rabia Nazik Yüksel
- Department of Psychiatry, Numune Education and Research Hospital, Ankara, Turkey
| | - Vahap Ozan Kotan
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Erol Göka
- Department of Psychiatry, Numune Education and Research Hospital, Ankara, Turkey
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Pitkänen T, Levola JM, de la Fuente J, Cabello M. Identifying psychosocial difficulties of inpatients with substance use disorders: evaluation of the usefulness of the PARADISE24 for clinical practise. Disabil Rehabil 2018; 42:130-136. [PMID: 30183423 DOI: 10.1080/09638288.2018.1493543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: Improvements in overall functioning and well-being are important goals in the treatment of substance use disorders. The aim of the current study was to evaluate the usefulness of the PARADISE24 instrument for studying the scope and severity of psychosocial difficulties by comparing the results with other measures in the context of substance use disorders.Materials and methods: This cross-sectional study included two independent inpatient samples. The first sample consisted of 80 interviews including the PARADISE24 and 10 other measures. The second sample consisted of the responses of 1082 inpatients to a self-administered PARADISE24 questionnaire.Results: Inpatients with substance use disorders had experienced a wide range of psychosocial difficulties and the two samples produced similar results. Highest scores were observed for emotional difficulties. The PARADISE24 showed convergent validity with measures of disability and depressive symptoms and discriminant validity with personality traits and environmental factors (i.e., social support and caretaker's empathy). Psychosocial difficulties were inversely associated with quality of life and self-assessed health.Conclusion: The PARADISE24 provides a wide range of useful information on psychosocial difficulties for clinical work and it can be used as a self-administered questionnaire in the evaluation and treatment of substance use disorders.Implications for rehabilitationIndividuals undergoing inpatient treatment for substance use disorders experience various and severe psychosocial difficulties.The PARADISE24 is an evidence-based instrument for assessing the scope and severity of 24 common psychosocial difficulties among neurological and psychiatric disorders.The PARADISE24 also offers a time-efficient method which can be used as a self-administered questionnaire in the context of substance use disorders.Comparison between the PARADISE24 and 10 commonly used measures showed that the PARADISE24 covered a wide variety of clinically relevant issues in one questionnaire.
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Affiliation(s)
| | - Jonna M Levola
- Department of Psychiatry, Hyvinkää Hospital Area, Hospital District of Helsinki and Uusimaa, Finland
| | - Javier de la Fuente
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Spain
| | - Maria Cabello
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Spain.,National Institute of Health Carlos III, CIBER of Mental Health (CIBERSAM), Madrid, Spain
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de la Fuente J, Cabello M, Levola J, Caballero FF, Ayuso-Mateos JL, Pitkänen T. Validity of the PARADISE24 questionnaire in people with substance use disorders: A measure to assess psychosocial difficulties. Drug Alcohol Depend 2018; 187:66-71. [PMID: 29627408 DOI: 10.1016/j.drugalcdep.2018.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Psychosocial difficulties (PSDs) are common in people with substance use disorders (SUDs). The PARADISE24 has been shown to be an adequate tool for measuring PSDs in inpatients with SUDs. The aim of this study is to evaluate the psychometric properties of the PARADISE24 in a sample of patients with SUDs. METHODS 2637 participants with SUDs completed the PARADISE24 questionnaire during their treatment. The latent structure of the PARADISE24 questionnaire was analyzed in the outpatient sample by means of exploratory and confirmatory factor analysis (EFA and CFA). Metric invariance was then assessed in relation to the inpatient sample using multiple group CFA. Finally, evidences of known-groups validity were checked to test the ability of the questionnaire to differentiate between socio-demographic and clinical groups. RESULTS The one-factor model presented an adequate fit in both the EFA (CFI = 0.98; TLI = 0.98; RMSEA = 0.07) and the CFA (CFI = 0.98; TLI = 0.98; RMSEA = 0.07) solutions. The reliability of the scale was found to be high (α = 0.93). Strict metric invariance between inpatients and outpatients was achieved (RMSEA = 0.063; TLI = 0.983; CFI = 0.981). The PARADISE24 was able to discriminate between the inpatients and outpatients at both latent (d = 0.98) and observed levels (d = 0.86). CONCLUSIONS The PARADISE24 is a unidimensional tool that is reliable for assessing and comparing PSDs in both outpatients and inpatients with SUDs. Further research is required for evaluating the ability of the PARADISE24 to quantify longitudinal changes in PSDs.
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Affiliation(s)
- Javier de la Fuente
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain
| | - Maria Cabello
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain; Centro de Investigation Biomédica en Red de Salud Mental, Cibersam, C/Diego de León, 62, 28006, Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), C/Diego de León, 62, 28006, Madrid, Spain.
| | - Jonna Levola
- Department of Psychiatry, Hyvinkää Hospital Area, Hospital District of Helsinki and Uusimaa, Sairaalankatu 1, 05850, Hyvinkää, Finland
| | - Francisco Félix Caballero
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain; Centro de Investigation Biomédica en Red de Salud Mental, Cibersam, C/Diego de León, 62, 28006, Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), C/Diego de León, 62, 28006, Madrid, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049, Madrid, Spain; Centro de Investigation Biomédica en Red de Salud Mental, Cibersam, C/Diego de León, 62, 28006, Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), C/Diego de León, 62, 28006, Madrid, Spain
| | - Tuuli Pitkänen
- A-Clinic Foundation, Ratamestarinkatu 7 A, 00520, Helsinki, Finland
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Wagner V, Acier D, Dietlin JE. Mediation of time perspectives on inclinations to use alcohol and motivation to change relationship. J Clin Psychol 2018; 74:1854-1866. [PMID: 29756291 DOI: 10.1002/jclp.22637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/07/2018] [Accepted: 04/13/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Trajectories of change accompanying alcohol-specialized care can be affected by numerous variables. Massive urges to drink can substantially hamper personal motivation to change. However, time perspective could also play an indirect role in this association. This research explores whether time perspectives mediates the relationship between inclinations to use or not to use alcohol and patients' motivation to change. DESIGN The sample included 150 outpatients in care for their problematic alcohol use. Models of mediation were planned. RESULTS At the entry in care, three specific time perspectives, Past Negative, Present Fatalistic, and Future, acted as discrete mediators. CONCLUSIONS These findings highlight underlying mechanisms connecting inclinations to use or to avoid the substance and the patient's motivation to change. Time perspective could also be an interesting intervention target in existing alcohol-specialized treatment programs.
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Affiliation(s)
- Vincent Wagner
- University of Nantes.,Beausejour Addiction Care, Support, and Prevention Center
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Spies M, Brütt AL, Buchholz A. Content comparison of guideline-recommended instruments used in treatment for alcohol use disorders. Disabil Rehabil 2018; 41:1682-1689. [PMID: 29397779 DOI: 10.1080/09638288.2018.1433724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Practice guidelines recommend the use of standardized instruments in the treatment of alcohol use disorders (AUDs); however, the extent to which these instruments assess patients' functioning is unclear. The aim of this study was to examine the domains of functioning and contextual factors contained in guideline-recommended instruments, using the International Classification of Functioning, Disability, and Health (ICF) as a reference. MATERIALS AND METHODS We identified instruments by reviewing AUD treatment guidelines used in Germany, Canada, Australia and New Zealand, United Kingdom, and United States. We included instruments which were available in English free of charge, we excluded instruments developed solely for diagnostic or epidemiological purposes and those for children or adolescents. Following a standardized set of rules, two health care researchers identified the concepts contained in the items on the instruments and independently linked them to ICF categories. RESULTS A total of 10 instruments were included. Among 517 items, 752 meaningful concepts (MCs) were derived, and 622 of them were linked to the ICF. Inter-rater agreement was κ = 0.61. One hundred eighty eight MCs referred to personal factors, 175 to body functions, 168 to activity and participation, and 91 to environmental factors. The most frequently linked ICF chapter was b1 (mental functions). CONCLUSIONS Instruments recommended in AUD treatment guidelines vary considerably in their assessment of patients' functioning and contextual factors. Within the investigated instruments, environmental factors are under-represented in comparison to body functions and personal factors. ICF linkage provides guidance for clinicians and researchers in the selection of appropriate instruments. Implications for rehabilitation Since instruments that are recommended in alcohol treatment guidelines vary considerably in respect the functioning domains and context factors they cover, it may be challenging for clinicians to select instruments relevant to their treatment context. Using the ICF as framework, our results provide guidance for clinicians in how to select appropriate instruments. Within the investigated instruments, environmental factors and activities and participation are under-represented in comparison to body functions and personal factors. Clinicians may employ AUD-unspecific or ICF-based instruments to cover these components if needed.
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Affiliation(s)
- Maren Spies
- a Department for Medical Psychology , University Medical Centre , Hamburg , Germany
| | - Anna Levke Brütt
- a Department for Medical Psychology , University Medical Centre , Hamburg , Germany.,b Department of Health Services Research , Carl von Ossietzky University , Oldenburg , Germany
| | - Angela Buchholz
- a Department for Medical Psychology , University Medical Centre , Hamburg , Germany
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The association of alcohol use and quality of life in depressed and non-depressed individuals: a cross-sectional general population study. Qual Life Res 2017; 27:1217-1226. [DOI: 10.1007/s11136-017-1741-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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Heterogeneity of emotional and interpersonal difficulties in alcohol-dependence: A cluster analytic approach. J Affect Disord 2017; 217:163-173. [PMID: 28411505 DOI: 10.1016/j.jad.2017.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/22/2017] [Accepted: 04/02/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Emotional and interpersonal impairments have been largely reported in alcohol-dependence, and their role in its development and maintenance is widely established. However, earlier studies have exclusively focused on group comparisons between healthy controls and alcohol-dependent individuals, considering them as a homogeneous population. The variability of socio-emotional profiles in this disorder thus remains totally unexplored. The present study used a cluster analytic approach to explore the heterogeneity of affective and social disorders in alcohol-dependent individuals. METHODS 296 recently-detoxified alcohol-dependent patients were first compared with 246 matched healthy controls regarding self-reported emotional (i.e. alexithymia) and social (i.e. interpersonal problems) difficulties. Then, a cluster analysis was performed, focusing on the alcohol-dependent sample, to explore the presence of differential patterns of socio-emotional deficits and their links with demographic, psychopathological and alcohol-related variables. RESULTS The group comparison between alcohol-dependent individuals and controls clearly confirmed that emotional and interpersonal difficulties constitute a key factor in alcohol-dependence. However, the cluster analysis identified five subgroups of alcohol-dependent individuals, presenting distinct combinations of alexithymia and interpersonal problems ranging from a total absence of reported impairment to generalized socio-emotional difficulties. CONCLUSIONS Alcohol-dependent individuals should no more be considered as constituting a unitary group regarding their affective and interpersonal difficulties, but rather as a population encompassing a wide variety of socio-emotional profiles. Future experimental studies on emotional and social variables should thus go beyond mere group comparisons to explore this heterogeneity, and prevention programs proposing an individualized evaluation and rehabilitation of these deficits should be promoted.
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Huỳnh C, Caron J, Pelletier M, Liu A, Fleury MJ. A Developmental Perspective in Mental Health Services Use Among Adults with Mental Disorders. J Behav Health Serv Res 2017; 45:389-420. [PMID: 28733714 DOI: 10.1007/s11414-017-9562-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined factors associated with mental health services (MHS) use by individuals with mental disorders within a developmental perspective of adulthood. Bivariate and multivariate analyses were conducted separately for each developmental stage on independent variables using the Andersen's behavioral health service model. For 18-29-year-old emerging adults (n = 141), autonomy, daily life/relations, Internet searching, alcohol dependence, cognitive impulsiveness, number of stressful events, and self-harm were associated with MHS use. For 30-49-year olds (n = 292), being female, country of origin, being on welfare, social integration, Internet searching, and number of stressful events were associated with MHS use. For 50-64-year-old middle-aged adults (n = 126), current occupation was associated with MHS use. Developing online resources for emerging adults may increase MHS use. For 30-49-year olds, outreach should target male, immigrants, and individuals less socially integrated and on welfare. For middle-aged adults, workplace programs that reduce stigma and offer psychological help could increase MHS use.
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Affiliation(s)
- Christophe Huỳnh
- Institut universitaire sur les dépendances, Centre intégré universitaire de santé et des services sociaux du Centre-Sud-de-l'Île-de-Montréal, 950 rue de Louvain Est, Montreal, QC, H2M 2E8, Canada.
- Department of Psychiatry, Douglas Hospital Research Centre, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
| | - Jean Caron
- Department of Psychiatry, Douglas Hospital Research Centre, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Marilou Pelletier
- Institut universitaire sur les dépendances, Centre intégré universitaire de santé et des services sociaux du Centre-Sud-de-l'Île-de-Montréal, 950 rue de Louvain Est, Montreal, QC, H2M 2E8, Canada
| | - Aihua Liu
- Department of Psychiatry, Douglas Hospital Research Centre, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Marie-Josée Fleury
- Institut universitaire sur les dépendances, Centre intégré universitaire de santé et des services sociaux du Centre-Sud-de-l'Île-de-Montréal, 950 rue de Louvain Est, Montreal, QC, H2M 2E8, Canada
- Department of Psychiatry, Douglas Hospital Research Centre, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
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The epidemiology of alcohol use in Izmir, Turkey: drinking pattern, impairment and help-seeking. Soc Psychiatry Psychiatr Epidemiol 2017; 52:887-899. [PMID: 28220214 DOI: 10.1007/s00127-017-1345-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/17/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE There is no report on various patterns of alcohol drinking and related impairment, help-seeking in Turkey. We investigated the 12-month prevalence and correlates of drinking patterns and alcohol use disorders in the general population of Izmir-Turkey, with further analyses on role impairment and help-seeking. METHOD A multi-stage clustered area probability sample of adult household residents in the Izmir Metropolitan Area was assessed using the Composite International Diagnostic Interview 2.1 (n = 4011). Estimation focused on prevalence and correlates of 12-month drinking pattern and DSM-IV alcohol use disorders. The 12-month drinking pattern included groups of non-regular users, regular non-heavy drinkers, regular heavy drinkers, and alcohol abuse disorder and alcohol dependence. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, and were assessed with Short Form-36 for functional impairments. Multinomial logistic regression was used for underlying associations between the covariates and the drinking patterns. RESULTS The rate of lifetime alcohol abstinence was 52.3% while the prevalence of past-year users was 14.8%. The 12-month prevalence estimates of regular heavy drinkers, and alcohol abuse disorder and dependence were 2.5%, 3.2 and 1.6%, respectively. Any of the drinking patterns and alcohol use disorders was associated with male gender, and higher levels of education, monthly income and socioeconomic status. Alcohol dependence was associated with mental health impairment but not with physical impairment. The 12-month rates of help-seeking in alcohol abuse and dependence were 11.6 and 16.5%. CONCLUSION Although alcohol use disorders are lower than estimates of Western countries, alcohol use constitute a major reason of disability with prominent treatment gap.
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Bora E, Zorlu N. Social cognition in alcohol use disorder: a meta-analysis. Addiction 2017; 112:40-48. [PMID: 27287050 DOI: 10.1111/add.13486] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/14/2016] [Accepted: 06/02/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Emre Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia.,6328 Sok no:38/2, Yali Mahallesi, Izmir, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Ageing of people with Down's syndrome: a systematic literature review from 2000 to 2014. Int J Rehabil Res 2016; 39:20-8. [PMID: 26626417 DOI: 10.1097/mrr.0000000000000147] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Life expectancy of people with Down's syndrome (DS) has increased considerably, now exceeding 60 years. People with DS start to get old around the age of 45. By referring to the WHO's International Classification of Functioning, Disability and Health (ICF) biopsychosocial perspective, this study aimed to present an up-to-date review of the past 14 years of literature concerning the ageing of people with DS. PUBMED, PsycInfo and the Social Sciences Citation Index were searched for studies published between 2000 and 2014. Studies were selected if they were written in English, focused on people more than 45 years of age with DS, and if terms related to DS and ageing appeared in either the title or the abstract. A total of 30 studies were retrieved and their meaningful concepts were linked to the ICF. In total, 38 ICF categories were identified that were mainly related to intellectual functions (b117) (19%), general metabolic functions (b540) (7.4%), mobility of joint functions (b710), muscle power functions (b730) (4.2%), gait pattern functions (b770) (4.2%) and structure of the brain (s110) (4.3%). Only two studies considered environmental factors, and only one considered the joint analysis of health condition and environmental factors. Data about the ageing of people with DS are predominantly based on medical evaluations and descriptions of their physical impairments. Few attempts have been made towards a comprehensive assessment of elderly people with DS with a joint analysis of their health condition and its interaction with environmental factors.
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Spies M, Maschler C, Buchholz A. [Participation restrictions in substance use disorders : Registration by screening and assessment instruments]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1154-61. [PMID: 27492317 DOI: 10.1007/s00103-016-2406-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Substance use disorders can contribute to severe participation restrictions. Whether these participation restrictions are covered by assessment instruments that are frequently used in addiction treatment services is not known. The international Classification of Functioning, Disability and Health (ICF) provides a framework to compare the content of different assessments. OBJECTIVES The aim of this study was to investigate whether assessments that are frequently used in German addiction treatment services, cover participation restrictions according to the ICF. MATERIALS AND METHODS In the summer of 2015, we asked German addiction treatment services to participate in an online survey. Addiction treatment services were approached via the mailing lists of German associations of addiction treatment. Respondents were asked to indicate which assessments from a list of frequently used assessment instruments they were using in their treatment service. The most frequently used assessments were then linked to components of the ICF. RESULTS A total of N = 177 addiction treatment services responded to the survey. Most of them offered long-term rehabilitation treatment (n = 97; 61 %) or counselling services (n = 44; 28 %). Twelve assessments were used by more than 10 % of the respondents. The analysis revealed a total of 491 so-called meaningful concepts that could be linked to components of the ICF. Of these, 95 (16 %) referred to the ICF component activity and participation. CONCLUSIONS Frequently used assessments in addiction treatment services include contents of the ICF component activity and participation to a substantial degree. However, this does not mean by default that these assessments can be used to assess participation restriction in a meaningful way.
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Affiliation(s)
- Maren Spies
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Catherine Maschler
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Angela Buchholz
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
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Huỳnh C, Caron J, Fleury MJ. Mental health services use among adults with or without mental disorders: Do development stages matter? Int J Soc Psychiatry 2016; 62:434-51. [PMID: 27074802 DOI: 10.1177/0020764016641906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Mental health services (MHS) use is a complex behaviour that does not only concern individuals with current mental disorder. To date, few studies have examined age-related contextualisation of MHS use. Reasons for seeking help may vary according to development stages in adulthood. AIMS This study aimed to determine which predisposing, enabling and need factors, using Andersen's model, were associated with MHS use according to adult development stages among individuals with or without current psychiatric diagnosis. METHODS Three age groups were examined: 18- to 29-year-olds (n = 775), 30- to 49-year-olds (n = 1,560) and 50- to 64-year-olds (n = 960). Data were obtained from the Montreal Longitudinal Catchment Area Study. Bivariate and multivariate logistic regression analyses were conducted for each age group separately to determine which predisposing, enabling and need factors were associated with MHS use in the past 12 months. RESULTS For 18- to 29-year-olds, one enabling factor (Internet search) and two need factors (presence of major depressive disorder and number of stressful events) were positively associated with MHS use. For 30- to 49-year-olds, one predisposing factor (family history of mental disorder), four enabling factors (not currently working or in school, perceiving neighbourhood disorder, social cohesion and Internet searching) and one need factor (major depressive disorder) correlated with help seeking. For 50- to 64-year-olds, two predisposing factors (family history of mental disorder and higher self-perceived stigma), two enabling factors (low satisfaction in personal relationship and Internet searching) and one need factor (alcohol dependence) were associated with MHS use. CONCLUSIONS Factors associated with MHS use differ according to adult development stages. Programmes and policies should be based on age-related contextualisation to increase MHS use.
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Affiliation(s)
- Christophe Huỳnh
- Centre de réadaptation en dépendance de Montréal - Institut universitaire, Montréal, QC, Canada Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Jean Caron
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Marie-Josée Fleury
- Centre de réadaptation en dépendance de Montréal - Institut universitaire, Montréal, QC, Canada Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, QC, Canada
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Vederhus JK, Pripp AH, Clausen T. Quality of Life in Patients with Substance Use Disorders Admitted to Detoxification Compared with Those Admitted to Hospitals for Medical Disorders: Follow-Up Results. Subst Abuse 2016; 10:31-7. [PMID: 27226719 PMCID: PMC4874746 DOI: 10.4137/sart.s39192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/17/2016] [Accepted: 04/25/2016] [Indexed: 12/20/2022]
Abstract
Quality of life (QoL) in patients admitted to a general hospital was compared with those admitted to a detoxification unit for the treatment of substance use disorder (SUD). This study combines data from two separate data collections: a cross-sectional study in a general hospital unit (somatic sample, N = 519) and a follow-up study in a detoxification unit (SUD sample, N = 140). A total of 659 patients recruited during 2008-2013 were included in this study. All patients completed a generic QoL questionnaire at inclusion, and the SUD sample also completed it at the six-month follow-up. SUD patients experienced comparably low physical QoL and had significantly lower psychological, social, and existential QoL domain scores when compared with the somatic sample. Mental distress and having a SUD were the major factors explaining variations in QoL, with both influencing QoL negatively. In the SUD sample, QoL improved moderately at the six-month follow-up with less improvement for the domain relationship to a partner. To facilitate the recovery of SUD patients, clinicians must view their patients' situation holistically and invest efforts into the different life domains affected by poor QoL.
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Affiliation(s)
| | - Are Hugo Pripp
- Oslo Centre for Biostatistics and Epidemiology (OCBE), Oslo University Hospital, Oslo, Norway
| | - Thomas Clausen
- Addiction Unit, Sørlandet Hospital HF, Kristiansand, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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Scaratti C, Leonardi M, Sattin D, Schiavolin S, Willems M, Raggi A. Work-related difficulties in patients with traumatic brain injury: a systematic review on predictors and associated factors. Disabil Rehabil 2016; 39:847-855. [DOI: 10.3109/09638288.2016.1162854] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chiara Scaratti
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Davide Sattin
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Michelle Willems
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
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Perceived quality of life, 6 months after detoxification: Is abstinence a modifying factor? Qual Life Res 2016; 25:2315-22. [PMID: 26995560 PMCID: PMC4980398 DOI: 10.1007/s11136-016-1272-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/08/2022]
Abstract
Purpose Patients with a substance use disorder (SUD), admitted for detoxification, often suffer from a poor quality of life (QoL). We set out to monitor QoL, together with substance use, in a departure from the usual norm of measuring substance use alone as a treatment outcome. Literature searches revealed scant knowledge of how QoL is influenced. With this in mind, we aimed to investigate whether total abstinence, prior to follow-up, could influence QoL. Methods We studied a prospective cohort of 140 patients admitted for inpatient detoxification treatment at Sørlandet Hospital (Norway), from September 2008 to August 2010. QoL was measured by a generic five-item questionnaire, the QoL-5. The extremes of this scale ranged from the worst possible rating of 0.1 to 0.9, as the best. A norm for the general population was benchmarked at 0.69. Change in QoL was calculated by subtracting baseline QoL from that achieved at the 6-month follow-up interview; linear regression modeling was used to study the influence of individual QoL predictors. Results The mean QoL at baseline was 0.46, 39 % below that of the general reference population. By applying the clinical interpretation of the scale, we found a modest overall mean improvement in QoL at follow-up (0.11 points); the greatest increases were seen for patients with the lowest baseline QoL scores. Abstinence prior to follow-up correlated with improved QoL, while living alone and psychological distress were negative influences. Conclusions For patients with a SUD, clinicians should emphasize that abstinence may help to improve their QoL.
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Maribo T, Petersen KS, Handberg C, Melchiorsen H, Momsen AMH, Nielsen CV, Leonardi M, Labriola M. Systematic Literature Review on ICF From 2001 to 2013 in the Nordic Countries Focusing on Clinical and Rehabilitation Context. J Clin Med Res 2016; 8:1-9. [PMID: 26668676 PMCID: PMC4676339 DOI: 10.14740/jocmr2400w] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2015] [Indexed: 11/23/2022] Open
Abstract
We present a systematic review on International Classification of Functioning, Disability and Health (ICF) used in the Nordic countries from 2001 through 2013, describing and quantifying the development in utilization of ICF, and describe the extent to which the different components of the ICF have been used. A search was conducted in EMBASE, MEDLINE and PsycInfo. Papers from Nordic countries were included if ICF was mentioned in title or abstract. Papers were assigned to one of eight categories covering the wide rehabilitation area; furthermore, area of focus was assigned. Use of ICF components and intervention were coded in papers categorized as "clinical and/or rehabilitation contexts" or "non-clinical contexts". One hundred seventy papers were included, of these 99 papers were from the categories "clinical and/or rehabilitation contexts" or "non-clinical contexts". Forty-two percent of the 170 included papers were published in the period 2011 - 2013. There was an increase in ICF-relevant papers from 2001 to 2013, especially in the categories "clinical and/or rehabilitation contexts" and "non-clinical contexts". The most represented focus areas were neurology, musculoskeletal, and work-related areas. All five or at least four ICF components were mentioned in the results or discussions in most papers, and activity was most frequently mentioned.
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Affiliation(s)
- Thomas Maribo
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Kirsten S. Petersen
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Charlotte Handberg
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Hanne Melchiorsen
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | | | - Claus V. Nielsen
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Matilde Leonardi
- Neurology Public Health and Disability Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy
| | - Merete Labriola
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
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Sabariego C, Coenen M, Ballert C, Cabello M, Leonardi M, Anczewska M, Pitkänen T, Raggi A, Mellor B, Covelli V, Świtaj P, Levola J, Schiavolin S, Chrostek A, Bickenbach J, Chatterji S, Cieza A. Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a 'Horizontal Epidemiology' Approach. PLoS One 2015; 10:e0141322. [PMID: 26675663 PMCID: PMC4682947 DOI: 10.1371/journal.pone.0141322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/07/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Persons with brain disorders experience significant psychosocial difficulties (PSD) in daily life, e.g. problems with managing daily routine or emotional lability, and the level of the PSD depends on social, physical and political environments, and psychologic-personal determinants. Our objective is to determine a brief set of environmental and psychologic-personal factors that are shared determinants of PSD among persons with different brain disorders. METHODS Cross-sectional study, convenience sample of persons with either dementia, stroke, multiple sclerosis, epilepsy, migraine, depression, schizophrenia, substance dependence or Parkinson's disease. Random forest regression and classical linear regression were used in the analyses. RESULTS 722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family. CONCLUSIONS The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24.
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Affiliation(s)
- Carla Sabariego
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
- * E-mail:
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | | | - Maria Cabello
- Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | - Marta Anczewska
- Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | - Blanca Mellor
- Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Venusia Covelli
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | - Piotr Świtaj
- Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Jonna Levola
- A-Clinic Foundation, Helsinki, Finland
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
- Division of Neurosurgery II, Neurological Institute Carlos Besta (IRCCS) Foundation, Milan, Italy
| | - Anna Chrostek
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | | | - Somnath Chatterji
- Department of Measurement and Health Information Systems, Multi-Country Studies, World Health Organization, Geneva, Switzerland
| | - Alarcos Cieza
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, United Kingdom
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Cieza A, Anczewska M, Ayuso-Mateos JL, Baker M, Bickenbach J, Chatterji S, Hartley S, Leonardi M, Pitkänen T. Understanding the Impact of Brain Disorders: Towards a 'Horizontal Epidemiology' of Psychosocial Difficulties and Their Determinants. PLoS One 2015; 10:e0136271. [PMID: 26352911 PMCID: PMC4564202 DOI: 10.1371/journal.pone.0136271] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 08/02/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To test the hypothesis of ‘horizontal epidemiology’, i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders. Study Design A multi-method study involving systematic literature reviews, content analysis of patient-reported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson’s disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional study including a convenience sample of persons with one of the nine brain disorders. PSDs endorsed by at least 25% of patients with a brain disorder were considered associated with the disorder. PSD were considered common across disorders if associated to 5 out of the 9 brain disorders and if among the 5 both neurological and psychiatric conditions were represented. Setting The data collection protocol with 64 PSDs and 20 determinants was used to collect data from a convenience sample of 722 persons in four specialized health care facilities in Europe. Results 57 of the PSDs and 16 of the determinants included in the protocol were found to be experienced across brain disorders. Conclusion This is the first evidence that supports the hypothesis of horizontal epidemiology in brain disorders. This result challenges the brain disorder-specific or vertical approach in which clinical and epidemiological research about psychosocial difficulties experienced in daily life is commonly carried in neurology and psychiatry and the way in which the corresponding health care delivery is practiced in many countries of the world.
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Affiliation(s)
- Alarcos Cieza
- Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, United Kingdom
- Department of Medical Informatics, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich, Germany
- Swiss Paraplegic Research, Nottwil, Switzerland
- * E-mail:
| | - Marta Anczewska
- Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Jose Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Madrid, Spain
| | - Mary Baker
- European Brain Council, Brussels, Belgium
| | | | - Somnath Chatterji
- Multi-Country Studies, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Sally Hartley
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
- The London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
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Raggi A, Covelli V, Schiavolin S, Scaratti C, Leonardi M, Willems M. Work-related problems in multiple sclerosis: a literature review on its associates and determinants. Disabil Rehabil 2015. [DOI: 10.3109/09638288.2015.1070295] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Maurage F, de Timary P, Tecco JM, Lechantre S, Samson D. Theory of Mind Difficulties in Patients with Alcohol Dependence: Beyond the Prefrontal Cortex Dysfunction Hypothesis. Alcohol Clin Exp Res 2015; 39:980-8. [DOI: 10.1111/acer.12717] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 02/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- François Maurage
- Université catholique de Louvain (FM, PdT, DS); Louvain-la-Neuve Belgium
- Centre Hospitalier Universitaire (FM, JMT, SL); Chêne aux Haies, Ambroise Paré; Mons Belgium
| | - Philippe de Timary
- Université catholique de Louvain (FM, PdT, DS); Louvain-la-Neuve Belgium
| | - Juan Martin Tecco
- Centre Hospitalier Universitaire (FM, JMT, SL); Chêne aux Haies, Ambroise Paré; Mons Belgium
| | - Stéphane Lechantre
- Centre Hospitalier Universitaire (FM, JMT, SL); Chêne aux Haies, Ambroise Paré; Mons Belgium
| | - Dana Samson
- Université catholique de Louvain (FM, PdT, DS); Louvain-la-Neuve Belgium
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