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Bahji A. Navigating the Complex Intersection of Substance Use and Psychiatric Disorders: A Comprehensive Review. J Clin Med 2024; 13:999. [PMID: 38398311 PMCID: PMC10889170 DOI: 10.3390/jcm13040999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
The co-occurrence of substance use disorders (SUDs) and psychiatric conditions, often referred to as comorbidity or concurrent disorders, presents intricate challenges in both diagnosis and treatment. This comprehensive narrative review aims to synthesize and critically evaluate the existing evidence surrounding the management of individuals with comorbid SUDs and psychiatric disorders. Comorbidity in these domains carries profound implications for clinical practice, research, and policymaking, emphasizing the need for a holistic understanding of the intricate dynamics that arise when these conditions coexist. This review explores recent research findings, evidence-based guidelines, and emerging trends within the field, offering valuable insights for clinicians, researchers, and policymakers seeking to navigate the complex terrain of comorbidity in substance use and psychiatric disorders.
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Affiliation(s)
- Anees Bahji
- Departments of Psychiatry and Community Health Sciences & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2R 1N4, Canada
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Zhou T, Salman D, McGregor A. mHealth Apps for the Self-Management of Low Back Pain: Systematic Search in App Stores and Content Analysis. JMIR Mhealth Uhealth 2024; 12:e53262. [PMID: 38300700 PMCID: PMC10870204 DOI: 10.2196/53262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/06/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND With the rapid development of mobile health (mHealth) technology, many health apps have been introduced to the commercial market for people with back pain conditions. However, little is known about their content, quality, approaches to care for low back pain (LBP), and associated risks of use. OBJECTIVE The aims of this research were to (1) identify apps for the self-management of LBP currently on the market and (2) assess their quality, intervention content, theoretical approaches, and risk-related approaches. METHODS The UK iTunes and Google Play stores were initially searched for apps related to the self-management of LBP in May 2022. A repeat search in June 2023 was conducted to ensure that any relevant new apps developed in the last year were incorporated into the review. A total of 3 keywords recommended by the Cochrane Back and Neck Group were used to search apps "low back pain," "back pain," and "lumbago." The quality of the apps was assessed by using the 5-point Mobile App Rating Scale (MARS). RESULTS A total of 69 apps (25 iOS and 44 Android) met the inclusion criteria. These LBP self-management apps mainly provide recommendations on muscle stretching (n=51, 73.9%), muscle strengthening (n=42, 60.9%), core stability exercises (n=32, 46.4%), yoga (n=19, 27.5%), and information about LBP mechanisms (n=17, 24.6%). Most interventions (n=14, 78%) are consistent with the recommendations in the National Institute for Health and Care Excellence (NICE) guidelines. The mean (SD) MARS overall score of included apps was 2.4 (0.44) out of a possible 5 points. The functionality dimension was associated with the highest score (3.0), whereas the engagement and information dimension resulted in the lowest score (2.1). Regarding theoretical and risk-related approaches, 18 (26.1%) of the 69 apps reported the rate of intervention progression, 11 (15.9%) reported safety checks, only 1 (1.4%) reported personalization of care, and none reported the theoretical care model or the age group targeted. CONCLUSIONS mHealth apps are potentially promising alternatives to help people manage their LBP; however, most of the LBP self-management apps were of poor quality and did not report the theoretical approaches to care and their associated risks. Although nearly all apps reviewed included a component of care listed in the NICE guidelines, the model of care delivery or embracement of care principles such as the application of a biopsychosocial model was unclear.
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Affiliation(s)
- Tianyu Zhou
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - David Salman
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Alison McGregor
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Nyrop KA, Kelly EA, Teal R, Muss HB, Charlot M. Clinician perspectives on patient-centered conversations about weight management with patients with early breast cancer. Cancer 2023; 129:3128-3140. [PMID: 37691525 DOI: 10.1002/cncr.34591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 09/12/2023]
Abstract
BACKGROUND The aim of this study is to gather detailed insights from breast cancer (BC) clinicians on how to have patient-centered conversations about weight and weight management with women diagnosed with early BC. A high body mass index (BMI) is a risk factor for female BC, and many women diagnosed with BC experience unhealthy weight gain after their primary treatment. The oncology team has the opportunity to discuss the importance of healthy weight for BC prognosis and survival. METHODS The sample of community-based BC clinicians included the following: three Black clinicians, three White clinicians, and two clinicians who were neither Black nor White; six females and two males; and six MDs and two physician assistants or nurse practitioners. Semistructured telephone interviews were conducted with these clinicians regarding their experience with and insights into having healthy weight conversations during routine clinic visits. RESULTS Clinicians noted that weight-related conversations should focus less on BMI and weight loss and more on "healthy behavior." Clinicians looked for cues from their patients as to when they were ready for "healthy weight" counseling, receptive to diet/nutrition counseling and referrals, and ready to attempt behavioral change. Clinicians noted that encouraging physical activity could be especially challenging with patients accustomed to a sedentary lifestyle. CONCLUSIONS Clinic-based conversations about healthy weight are likely to be most productive for both patients and their treating oncologists during the post-primary treatment phase when patients are most receptive to behavioral change that enhances their prognosis and survival.
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Affiliation(s)
- Kirsten A Nyrop
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin A Kelly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Randall Teal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hyman B Muss
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marjory Charlot
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Maghfour J, Sivesind T, Piguet V, Dellavalle R, Ingram JR. From the Cochrane Library: Interventions for Hidradenitis Suppurativa. JMIR Dermatol 2022; 5:e29966. [PMID: 37632870 DOI: 10.2196/29966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/05/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jalal Maghfour
- Photomedicine and Photobiology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, United States
| | - Torunn Sivesind
- Dermatology Department, University of Colorado, Aurora, CO, United States
| | | | - Robert Dellavalle
- Dermatology Department, University of Colorado, Aurora, CO, United States
| | - John R Ingram
- Dermatology Department, Glamorgan House, University Hospital of Wales, Cardiff, United Kingdom
- Division of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
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Maghfour J, Sivesind TE, Dellavalle RP, Dunnick C. Trends in Hidradenitis Suppurativa Disease Severity and Quality of Life Outcome Measures: Scoping Review. JMIR Dermatol 2021; 4:e27869. [PMID: 37632807 PMCID: PMC10334968 DOI: 10.2196/27869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/04/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although there has been an increase in the number of randomized controlled trials evaluating treatment efficacy for hidradenitis suppurativa (HS), instrument measurements of disease severity and quality of life (QoL) are varied, making the compilation of data and comparisons between studies a challenge for clinicians. OBJECTIVE We aimed to perform a systematic literature search to examine the recent trends in the use of disease severity and QoL outcome instruments in randomized controlled trials that have been conducted on patients with HS. METHODS A scoping review was conducted in February 2021. The PubMed, Embase, Web of Science, and Cochrane databases were used to identify all articles published from January 1964 to February 2021. In total, 41 articles were included in this systematic review. RESULTS The HS Clinical Response (HiSCR) score (18/41, 44%) was the most commonly used instrument for disease severity, followed by the Sartorius and Modified Sartorius scales (combined: 16/41, 39%). The Dermatology Life Quality Index (18/41, 44%) and visual analogue pain scales (12/41, 29%) were the most commonly used QoL outcome instruments in HS research. CONCLUSIONS Randomized controlled trials conducted from 2013 onward commonly used the validated HiSCR score, while older studies were more heterogeneous and less likely to use a validated scale. A few (6/18, 33%) QoL measures were validated instruments but were not specific to HS; therefore, they may not be representative of all factors that impact patients with HS. TRIAL REGISTRATION National Institute of Health Research PROSPERO CRD42020209582; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020209582.
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Affiliation(s)
- Jalal Maghfour
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, United States
| | - Torunn Elise Sivesind
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Robert Paul Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
| | - Cory Dunnick
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
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Abstract
Objective: To identify, factors associated with obstetricians' treatment recommendations for pregnant women with an opioid use disorder (PWOUD), and to determine the prevalence of physicians waivered for buprenorphine as a medication-assisted treatment (MAT).Methods: We conducted a structured online survey of a nationally representative sample of 565 obstetrical physicians, with a response rate of 38%. Logistic regression models were derived to identify factors that influence treatment recommendations for PWOUD. The Clopper-Pearson method was used to derive the confidence interval (CI) for the number of physicians waivered for buprenorphine.Results: Approximately 77% of respondents had provided care for a PWOUD within the last year. Physicians reported that at least 75% of their PWOUD received Medicaid for prenatal care. The most common opioids used at patient presentation were prescription opioids, with the second most common being methadone. A total of 14.0% had buprenorphine waivers (95% CI: 11.6-16.7%), and among those waivered, 47% prescribed buprenorphine to PWOUD. Factors associated with buprenorphine waiver encompass referrals to community support services. The three most prominent factors associated with adherence to standard of care were: type of opioid at presentation, patient's choice, and physician's experience. Type of opioid was associated with methadone presentation, socioeconomic status, shared decision making and practice setting. Patient's choice was associated with physician preparedness and practice duration. Physician's experience was associated with referral to recovery-oriented services.Conclusions: Novel interventions are needed to (1) promote office-based treatment for opioid use disorder through continuing medical education, (2) provide physicians with access to recovery-oriented resources and (3) increase patient autonomy in healthcare decision making. These proposed evidence-based interventions will promote best practices for women and their infants and greater accessibility to standard of care.
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Affiliation(s)
- Heather Grimshaw Howard
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, FL, USA
| | - Katherine Freeman
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
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Povsic M, Oliver L, Jiandani NR, Perry R, Bottomley J. A structured literature review of interventions used in the management of nonalcoholic steatohepatitis (NASH). Pharmacol Res Perspect 2019; 7:e00485. [PMID: 31149341 PMCID: PMC6536401 DOI: 10.1002/prp2.485] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/18/2019] [Accepted: 04/26/2019] [Indexed: 12/18/2022] Open
Abstract
Nonalcoholic steatohepatitis (NASH) is a chronic, progressive disease, that can advance to fibrosis, cirrhosis, and hepatocellular carcinoma. Despite being a leading cause of liver transplantation, there are no approved pharmacological treatments. Our aim was to identify literature on management options in NASH. Our structured review of interventions treating NASH patients from English language publications between 1 January 2007 and 25 September 2017 elicited 48 eligible references. Lifestyle management was identified as the mainstay of NASH therapy. Vitamin E and pioglitazone reported reductions in steatosis; however, although recommended for some, no therapies are indicated in NASH. Multiple investigational treatments reported efficacy in mild-to-moderate fibrosis in Phase II/III NASH trials. Lifestyle management, although the focus of clinical guidelines, is insufficient for patients progressing to advanced fibrosis. With no clear guidelines for patients requiring interventions beyond lifestyle modification, long-term outcomes data are needed, particularly in patients with moderate-to-severe fibrosis.
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Abstract
INTRODUCTION Treatment of persistent genital arousal disorder (PGAD), as a chronic and disabling condition, implicates substantial compelling complexities. METHODS In this case series, seven women diagnosed with PGAD who were referred to the Sexual Dysfunction Unit of Psychotherapy Outpatient Clinic of Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey between 2006 and 2009 were included. All patients were previously resistant to other antidepressants, antipsychotics and antiepileptics. The additional details of PGAD onset, frequency, type and duration of arousal, previous pharmacological interventions, and maximum and maintenance doses of clomipramine were recorded. RESULTS All patients achieved a substantial symptomatic improvement with clomipramine within the follow-up period of 2-9 years. DISCUSSION Based on our study results, we recommend clomipramine in combination with psychotherapy as the treatment of choice in PGAD and to be used before any invasive procedure such as electroconvulsive therapy (ECT) or surgery.
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Affiliation(s)
- Ejder Akgun Yildirim
- a Department of Psychiatry , Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Psychotherapy Outpatient Clinic , Istanbul , Turkey
| | - Munevver Hacioglu Yildirim
- a Department of Psychiatry , Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Psychotherapy Outpatient Clinic , Istanbul , Turkey
| | - Elif Carpar
- b Department of Psychiatry , Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Irmak Sarac
- c Department of Gynecology and Obstetrics , Surp Agop Hospital , Istanbul , Turkey
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Saariaho AS, Saariaho TH, Mattila AK, Ohtonen P, Joukamaa MI, Karukivi M. Alexithymia and depression in the recovery of chronic pain patients: a follow-up study. Nord J Psychiatry 2017; 71:262-269. [PMID: 28413937 DOI: 10.1080/08039488.2016.1275782] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Childhood adversities and emotional dysregulation are connected with chronic pain, alexithymia, and depression. Longitudinal studies exploring the impact of their co-occurrence on the pain situation are rare. AIMS The influence of alexithymia, depression, baseline pain situation, and treatment options on the course of chronic pain in a clinical sample was studied. METHODS The baseline data was collected from chronic pain patients (n = 154) before their first pain clinic visit, and the follow-up data after 1 year by self-report questionnaires. Study variables consisted of pain intensity, pain disability, alexithymia (TAS-20), depression (BDI-II), and treatment interventions. Statistical analyses were performed to find out differences between baseline and follow-up, as well as between alexithymic and non-alexithymic patients, and to estimate the effect of the treatment provided. RESULTS At follow-up, the majority of the patients had pain intensity and disability severe enough to disrupt with their daily living. None of treatment interventions was related to better outcome. Alexithymic patients reported more pain disability and depression at both baseline and at follow-up. The effect of alexithymia on pain disability was mediated by depression. The use of opioids was connected to alexithymia and depressiveness. Alexithymia and depression made a substantial contribution to poorer outcome. CONCLUSIONS Severe pain intensity and disability with depression and alexithymia predicted difficulties in achieving improvement. Depression and alexithymia probably impair compliance with treatment and adherence to interventions. Their co-occurrence with a more severe pain situation and with the use of opioids indicates psychological problems underlying the pain experience.
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Affiliation(s)
| | - Tom H Saariaho
- b Pain Clinic , Oulu University Hospital , Oulu , Finland
| | - Aino K Mattila
- c Department of Psychiatry , Tampere University Hospital , Tampere , Finland
| | - Pasi Ohtonen
- d Department of Anesthesiology and Surgery , Oulu University Hospital , Oulu , Finland
| | - Matti I Joukamaa
- e School of Health Sciences, Tampere University , Tampere , Finland
| | - Max Karukivi
- f Department of Psychiatry , University of Turku and Turku University Hospital, Turku Unit of Adolescent Psychiatry, Satakunta Hospital District , Pori , Finland
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Chun J, Shim H, Kim S. A Meta-Analysis of Treatment Interventions for Internet Addiction Among Korean Adolescents. Cyberpsychol Behav Soc Netw 2017; 20:225-231. [PMID: 28263660 DOI: 10.1089/cyber.2016.0188] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study comprehensively examined the effects of treatment interventions for Internet addiction among adolescents in South Korea through a meta-analysis. We analyzed 70 domestic master's theses and journal articles that reported on controlled studies and involved pre- and post-test analyses in the design. The dates of these publications fall between 2000 and 2015. The total effect size, calculated by random-effect analysis (g), revealed that interventions for the treatment of Internet addiction were effective (ES = 1.838). Meta-ANOVAs revealed differences between groups based on a theoretical model, intervention group size, and intervention duration. Integrative therapy produced larger effect sizes (ES = 2.794) compared to other treatment models such as cognitive behavioral therapy and reality therapy. Effect sizes for interventions, including nine to 12 people (ES = 2.178), were larger than those of interventions including more or fewer participants. Finally, treatment interventions that lasted 8 or more weeks revealed larger effect sizes (ES = 2.294) compared to shorter interventions. The study findings suggest directions for the development and effective operation of future Internet addiction interventions among Korean adolescents. Increasing the effectiveness of these interventions requires an integrative theoretical model, an intervention group size of nine to 12 participants, and a long-term intervention.
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Affiliation(s)
- JongSerl Chun
- Department of Social Welfare, Ewha Womans University , Seoul, South Korea
| | - HaiSun Shim
- Department of Social Welfare, Ewha Womans University , Seoul, South Korea
| | - Soyoun Kim
- Department of Social Welfare, Ewha Womans University , Seoul, South Korea
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Chiappelli F, Navarro AM, Moradi DR, Manfrini E, Prolo P. Evidence-Based Research in Complementary and Alternative Medicine III: Treatment of Patients with Alzheimer's Disease. Evid Based Complement Alternat Med 2006; 3:411-24. [PMID: 17173104 PMCID: PMC1697743 DOI: 10.1093/ecam/nel072] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Accepted: 09/15/2006] [Indexed: 11/14/2022]
Abstract
This paper presents the novel domain of evidence-based research (EBR) in the treatment of patients with Alzheimer's disease (AD) from the perspective of traditional medicine and of complementary and alternative medicine. In earlier lectures we have described the process of evidence-based medicine as a methodological approach to clinical practice that is directed to aid clinical decision-making. Here, we present a practical example of this approach with respect to traditional pharmacological interventions and to complementary and alternative treatments for patients with AD.
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Affiliation(s)
- Francesco Chiappelli
- Division of Oral Biology and Medicine, UCLA School of DentistryUSA
- PNIGroup, Inc.USA
- West Los Angeles Veterans Administration Medical CenterUSA
| | | | - David R. Moradi
- Division of Oral Biology and Medicine, UCLA School of DentistryUSA
| | | | - Paolo Prolo
- Division of Oral Biology and Medicine, UCLA School of DentistryUSA
- PNIGroup, Inc.USA
- West Los Angeles Veterans Administration Medical CenterUSA
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Abstract
Research has demonstrated that dementia sufferers may be victims of recent physical assault by family caregivers and other patients and staff in long-term care facilities. Some dementia sufferers have also been victims of violence at other points in their lives from events such as combat, physical and sexual abuse, natural and manmade disasters, and the like. These violent events may result in psychological trauma and the psychological aftermath of these violent incidents may last until death, if it is not treated. The purpose of this paper is to outline some intervention strategies regarding restraints for dementia sufferers who have a history of violence andfor whom little or no treatment has been provided. This paper is not intended to train trauma counseling specialists but to present common intervention strategies that may be fielded by long-term care staff to relieve unnecessary suffering.
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Affiliation(s)
- Raymond B Flannery
- The Massachusetts Department of Mental Health, Worcester State Hospital, USA
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