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van der Meer PB, Fuentes JJ, Kaptein AA, Schoones JW, de Waal MM, Goudriaan AE, Kramers K, Schellekens A, Somers M, Bossong MG, Batalla A. Therapeutic effect of psilocybin in addiction: A systematic review. Front Psychiatry 2023; 14:1134454. [PMID: 36846225 PMCID: PMC9947277 DOI: 10.3389/fpsyt.2023.1134454] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Psychedelic-assisted therapy [e.g., with lysergic acid diethylamide (LSD)] has shown promising results as treatment for substance use disorders (SUDs). Previous systematic reviews assessing the efficacy of psilocybin in SUDs only included clinical trials conducted in the last 25 years, but they may have missed clinical trials assessing the efficacy of psilocybin that were conducted before the 1980s, given much research has been done with psychedelics in the mid-20th century. In this systematic review, we specifically assessed the efficacy of psilocybin in patients with a SUD or non-substance-related disorder with no publication date restrictions in our search strategy. METHODS A systematic literature search was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines from the earliest published manuscript up to September 2, 2022, in seven electronic databases, including clinical trials in patients with a SUD or non-substance-related disorder evaluating the efficacy of psilocybin. RESULTS A total of four studies (six articles, of which two articles were long-term follow-up results from the same trial) were included in this systematic review. Psilocybin-assisted therapy was administered to n = 151 patients in a dose ranging from 6 to 40 mg. Three studies focused on alcohol use disorder, and one study on tobacco use disorder. In a pilot study (n = 10), the percentage of heavy drinking days decreased significantly between baseline and weeks 5-12 (mean difference of 26.0, 95% CI = 8.7-43.2, p = 0.008). In another single-arm study (n = 31), 32% (10/31) became completely abstinent from alcohol (mean duration of follow-up 6 years). In a double-blind, placebo-controlled randomized controlled trial (RCT, n = 95), the percentage of heavy drinking days during the 32-week double-blind period was significantly lower for psilocybin compared to placebo (mean difference of 13.9, 95% CI = 3.0-24.7, p = 0.01). In a pilot study (n = 15), the 7-day point prevalence of smoking abstinence at 26 weeks was 80% (12/15), and at 52 weeks 67% (10/15). CONCLUSION Only one RCT and three small clinical trials were identified assessing the efficacy of psilocybin combined with some form of psychotherapy in patients with alcohol and tobacco use disorder. All four clinical trials indicated a beneficial effect of psilocybin-assisted therapy on SUD symptoms. Larger RCTs in patients with SUDs need to evaluate whether psilocybin-assisted therapy is effective in patients with SUD.
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Affiliation(s)
- Pim B van der Meer
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Juan J Fuentes
- Addiction Program, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar, Barcelona, Spain.,Addiction Research Group, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Ad A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, Netherlands
| | - Jan W Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, Netherlands
| | - Marleen M de Waal
- Department of Research and Jellinek, Arkin Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands.,Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Anneke E Goudriaan
- Department of Research and Jellinek, Arkin Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands.,Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Kees Kramers
- Department of Pharmacology-Toxicology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Arnt Schellekens
- Nijmegen Institute for Science Practitioners in Addiction (NISPA), Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Metten Somers
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Albert Batalla
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
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Lortye SA, Will JP, Marquenie LA, Goudriaan AE, Arntz A, de Waal MM. Correction: Treating posttraumatic stress disorder in substance use disorder patients with co-occurring posttraumatic stress disorder: study protocol for a randomized controlled trial to compare the effectiveness of different types and timings of treatment. BMC Psychiatry 2022; 22:482. [PMID: 35854251 PMCID: PMC9295271 DOI: 10.1186/s12888-022-04092-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sera A. Lortye
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Joanne P. Will
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Loes A. Marquenie
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Anna E. Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands ,grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Arnoud Arntz
- grid.7177.60000000084992262Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Marleen M. de Waal
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
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de Waal MM, Christ C, Messman TL, Dekker JJM. Changes in Risk Perception After Sexual Victimization: Are We Following the Right Track? J Interpers Violence 2022; 37:NP11699-NP11719. [PMID: 31096834 PMCID: PMC9251736 DOI: 10.1177/0886260519848790] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sexual abuse is a major public health concern with detrimental effects on both mental and physical health. Several studies have reported that victims of sexual abuse have a decreased ability to recognize risk in potentially threatening situations compared with nonvictims, although others were not able to replicate this finding. In addition, although emotion dysregulation has been linked to risk perception and sexual victimization, results have been contradictory. To strengthen the theoretical framework needed for the development of interventions to reduce women's likelihood of sexual assault, it is crucial to further examine the role of emotion dysregulation in relation to sexual victimization history and risk perception. The aim of the current study was to examine cross-sectional associations between sexual victimization, emotion regulation difficulties, and risk perception. In our sample of 276 female college students, 40% reported lifetime sexual victimization, 14% reported recent sexual victimization, and 12% reported childhood sexual abuse. In contrast to our hypothesis, we did not find risk perception to be related to lifetime sexual victimization, childhood sexual victimization, or recent sexual victimization. In addition, we did not find evidence for the expected relationship between sexual victimization, risk perception, and emotion regulation difficulties. The discussion of the current study specifically highlights the need for a clear conceptualization of risk perception and provides recommendations for future studies. More sophisticated measurement methods could lead to a higher applicability of findings to real-life situations. The potential relationships between victimization, risk perception, and emotion dysregulation need further clarification to reach the ultimate goal of contributing to the prevention of victimization.
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Affiliation(s)
- Marleen M de Waal
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Carolien Christ
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest, The Netherlands
| | | | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
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Goudriaan AE, de Waal MM. Commentary on Nower et al: Patterns in pathways: underlying comorbidities and the importance of assessment. Addiction 2022; 117:2009-2010. [PMID: 35315144 PMCID: PMC9314676 DOI: 10.1111/add.15859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/24/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Anna E. Goudriaan
- Arkin Mental Health Care, Jellinekand Amsterdam Institute for Addiction ResearchAmsterdamThe Netherlands,Amsterdam UMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | - Marleen M. de Waal
- Arkin Mental Health Care, Jellinekand Amsterdam Institute for Addiction ResearchAmsterdamThe Netherlands,Amsterdam UMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
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de Waal MM, Blankers M, Lommerse NM, Kikkert MJ, Dekker JJM, Goudriaan AE. Economic Evaluation of the SOS Training to Reduce Victimization in Dual Diagnosis Patients. J Dual Diagn 2021; 17:333-343. [PMID: 34569438 DOI: 10.1080/15504263.2021.1965409] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Economic evaluations of interventions for dual diagnosis patients are scarce. A recent randomized controlled trial has supported the effectiveness of the Self-wise, Otherwise, Streetwise (SOS) training to reduce victimization in dual diagnosis patients. The purpose of the current study was to analyze the cost-effectiveness and cost-utility of the SOS training as an add-on to care as usual (CAU). METHODS We performed an economic evaluation from a societal perspective alongside the SOS trial. Participants were 250 dual diagnosis patients recruited at three locations from a large urban psychiatric service in the Netherlands. The main outcomes were treatment response for victimization and quality-adjusted life years (QALYs). Both costs and effects were measured across a 14-month follow-up. RESULTS There was no significant difference between CAU + SOS and CAU in total costs (mean difference €4,859; 95% CI [-€4,795 to €14,513]) and QALY gains (mean difference 0.0012; 95% CI [-0.05 to 0.05]). Significantly more participants in CAU + SOS achieved treatment response for victimization compared to CAU (68% vs. 54%; mean difference 0.14; 95% CI [0.02 to 0.26]). The cost-effectiveness analysis indicated an 83% likelihood that CAU + SOS resulted in a higher treatment response rate for victimization at higher costs compared to CAU. The cost-utility analysis indicated that adding SOS-training to CAU is probably not cost-effective at conventional willingness-to-pay levels for QALYs. CONCLUSIONS At a societal willingness-to-pay of €38,000 or more per extra treatment responder, adding SOS-training to usual care is probably more attractive than usual care alone with regard to cost-effectiveness. This is a considerable willingness to pay. However, the direct costs of offering the SOS training are expected to be minor. Our findings should be interpreted with caution due to the short follow-up period and absence of data on potential reductions in police and judicial costs other than prison costs.
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Affiliation(s)
- Marleen M de Waal
- Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands.,Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands.,Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands.,Trimbos Institute, Utrecht, The Netherlands
| | - Nick M Lommerse
- Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Martijn J Kikkert
- Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands.,Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands.,Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
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Lortye SA, Will JP, Marquenie LA, Goudriaan AE, Arntz A, de Waal MM. Treating posttraumatic stress disorder in substance use disorder patients with co-occurring posttraumatic stress disorder: study protocol for a randomized controlled trial to compare the effectiveness of different types and timings of treatment. BMC Psychiatry 2021; 21:442. [PMID: 34493253 PMCID: PMC8423329 DOI: 10.1186/s12888-021-03366-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment. METHODS In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger. DISCUSSION This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide. TRIAL REGISTRATION Netherlands Trial Register (NTR), Identifier: NL7885 . Registered 22 July 2019.
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Affiliation(s)
- Sera A. Lortye
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Joanne P. Will
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Loes A. Marquenie
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Anna E. Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands ,grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Arnoud Arntz
- grid.7177.60000000084992262Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Marleen M. de Waal
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
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van Hagen LJ, de Waal MM, Christ C, Dekker JJM, Goudriaan AE. Patient Characteristics Predicting Abstinence in Substance Use Disorder Patients With Comorbid Mental Disorders. J Dual Diagn 2019; 15:312-323. [PMID: 31566115 DOI: 10.1080/15504263.2019.1667043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
Objective: Patients with both a substance use disorder and comorbid mental disorder, or dual diagnosis, form a heterogeneous group with complex treatment needs. Dual diagnosis patients have worse treatment outcomes compared to patients with substance use disorders alone. There is a lack of research focusing on predictors of treatment outcome in dual diagnosis patients. The aim of this study was to identify patient characteristics associated with abstinence in dual diagnosis patients. Methods: In a cohort design, we examined associations between baseline demographic and clinical patient characteristics and abstinence at 14-month follow-up in 102 dual diagnosis patients undergoing treatment in an addiction-psychiatry service in Amsterdam. Immigration, employment, housing, age, emotion regulation, psychiatric symptoms, and frequency and nature of substance abuse were examined as possible predictors of abstinence. Patients were considered abstinent if they had refrained from any substance use in the 30 days prior to the follow-up assessment, as measured with the Timeline Follow Back method. Results: In a multiple logistic regression analysis corrected for treatment utilization, being a first- or second-generation immigrant was associated with lower odds of abstinence (OR = 5.13; 95% CI [1.63, 18.18]), as well as higher levels of depressive and anxiety symptoms at baseline (OR = 0.90; 95% CI [0.81, 0.99]). Gender, age, housing, employment, emotion regulation, frequency and nature of substance abuse, and the psychiatric symptoms positive symptoms, negative symptoms, and manic excitement and disorganization did not show a significant relationship with abstinence. Conclusions: The results indicate that being a first- or second-generation immigrant and experiencing more symptoms of depression and anxiety are predictive of non-abstinence. Attention for linguistic and cultural congruence of dual diagnosis treatments may enhance abstinence in immigrants. Additionally, addressing symptoms of depression and anxiety in dual diagnosis treatment may be beneficial for the maintenance of abstinence. More research is needed on factors influencing treatment success in dual diagnosis patients.
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Affiliation(s)
- Lisanne J van Hagen
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Marleen M de Waal
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carolien Christ
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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8
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de Waal MM, Dekker JJM, Kikkert MJ, Christ C, Chmielewska J, Staats MWM, van den Brink W, Goudriaan AE. Self-wise, Other-wise, Streetwise (SOS) training, an intervention to prevent victimization in dual-diagnosis patients: results from a randomized clinical trial. Addiction 2019; 114:730-740. [PMID: 30461111 PMCID: PMC6590185 DOI: 10.1111/add.14500] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/18/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Patients with co-occurring substance use and other mental disorders are vulnerable to crime victimization, yet no evidence-based preventive interventions exist. Our aim was to test the efficacy of a new intervention, Self-wise, Other-wise, Streetwise training (SOS training), to prevent victimization in these dual-diagnosis patients as an add-on to care as usual. DESIGN Multi-site single-blind parallel randomized controlled trial. SETTING Three sites within one psychiatric service in Amsterdam, the Netherlands. PARTICIPANTS Adult in-patients and out-patients with dual diagnosis (n = 250), who were predominantly male (70.4%), aged on average 42.1 years, and diagnosed with 3.7 DSM-IV disorders. INTERVENTION AND COMPARATOR Care as usual, consisting of pharmacotherapy combined with individual psychotherapy, group psychotherapy and/or supportive counselling (n = 125) was compared with care as usual plus SOS training: a 6-week, 12-session manualized group training focused on enhancing emotion regulation skills, conflict resolution skills and street skills (n = 125). MEASUREMENTS Victimization was assessed with the Safety Monitor, the Dutch equivalent of the International Crime Victims Survey, in a face-to-face assessment. The primary outcome measure was treatment response (yes/no), with 'yes' defined as reporting at least a 50% reduction in the number of past-year victimization incidents at the 14-month follow-up compared with baseline. Analyses were performed according to the intention-to-treat principle. FINDINGS The proportion of participants achieving treatment response for total victimization was 54.0% in the control group and 67.6% in the experimental group, a significant difference [odds ratio (OR) = 1.78, 95% confidence interval (CI) = 1.02-3.11, P = 0.042]. Treatment response for violent victimization was achieved by 68.7% of the control group and 79.3% of the experimental group (OR = 1.75, 95% CI = 0.91-3.34, P = 0.092). With a Bayes factor of 2.26, this result was inconclusive. CONCLUSIONS Among dual-diagnosis patients, care as usual plus Self-wise, Other-wise, Streetwise training was more effective in preventing victimization than care as usual alone.
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Affiliation(s)
- Marleen M. de Waal
- Department of Psychiatry, Amsterdam Institute for Addiction ResearchAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands,Department of ResearchArkin Mental Health CareAmsterdamthe Netherlands
| | - Jack J. M. Dekker
- Department of ResearchArkin Mental Health CareAmsterdamthe Netherlands,Department of Clinical PsychologyVU University AmsterdamAmsterdamthe Netherlands
| | | | - Carolien Christ
- Department of ResearchArkin Mental Health CareAmsterdamthe Netherlands,Department of PsychiatryGGZ inGeest and VU University Medical CenterAmsterdamthe Netherlands
| | - Jaga Chmielewska
- Arkin Mental Health CareDivision MentrumAmsterdamthe Netherlands
| | | | - Wim van den Brink
- Department of Psychiatry, Amsterdam Institute for Addiction ResearchAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction ResearchAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands,Department of ResearchArkin Mental Health CareAmsterdamthe Netherlands
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Eggink E, de Waal MM, Goudriaan AE. Criminal offending and associated factors in dual diagnosis patients. Psychiatry Res 2019; 273:355-362. [PMID: 30682557 DOI: 10.1016/j.psychres.2019.01.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 07/23/2018] [Revised: 12/10/2018] [Accepted: 01/13/2019] [Indexed: 12/24/2022]
Abstract
Dual diagnosis patients perpetrate crime more often than healthy individuals. Crime perpetration has major mental health consequences for the victim. Knowledge of factors related to perpetration is needed for the development of prevention programs. However, in dual diagnosis patients, very little is known about factors explaining criminal behavior. The current study investigated cross-sectional associations between demographic and clinical factors and perpetration of three crime types (violence, threat, and property crime) in 243 treatment-seeking dual diagnosis patients. In our sample, perpetration of violence was independently associated with younger age, severity of alcohol use problems, lifetime trauma exposure, and higher manic symptom scores. Expression of threat was independently associated with severity of alcohol use problems and higher manic symptom scores. Perpetration of property crime was independently associated with severity of alcohol and drug use problems. Remarkably, gender was not associated with any type of perpetration. These findings indicate that criminal offending is a significant problem among dual diagnosis patients and are a first step towards understanding the complex causal networks that lead to criminal perpetration. Future longitudinal research should investigate additional risk factors and establish causality to support the development of treatment programs to prevent criminal offending by dual diagnosis patients.
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Affiliation(s)
- Esmé Eggink
- Amsterdam UMC, University of Amsterdam, Department of General Practice, Amsterdam, the Netherlands; Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands
| | - Marleen M de Waal
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands; Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands.
| | - Anna E Goudriaan
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands; Department of Research, Arkin Mental Health Care, Amsterdam, the Netherlands
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10
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Christ C, de Waal MM, van Schaik DJF, Kikkert MJ, Blankers M, Bockting CLH, Beekman ATF, Dekker JJM. Prevention of violent revictimization in depressed patients with an add-on internet-based emotion regulation training (iERT): study protocol for a multicenter randomized controlled trial. BMC Psychiatry 2018; 18:29. [PMID: 29394919 PMCID: PMC5797346 DOI: 10.1186/s12888-018-1612-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/17/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psychiatric patients are at high risk of becoming victim of a violent crime compared to the general population. Although most research has focused on patients with severe mental illness, depressed patients have been demonstrated to be prone to victimization as well. Victimization is associated with more severe symptomatology, decreased quality of life, and high risk of revictimization. Hence, there is a strong need for interventions that focus on preventing violent revictimization. Since emotion dysregulation is associated with both victimization and depression, we developed an internet-based Emotion Regulation Training (iERT) to reduce revictimization in depressed patients. This study aims to evaluate the clinical and cost-effectiveness of iERT added to Treatment As Usual (TAU) in reducing incidents of violent revictimization among depressed patients with a recent history of victimization. Furthermore, this study aims to examine secondary clinical outcomes, and moderators and mediators that may be associated with treatment outcomes. METHODS In a multicenter randomized controlled trial with parallel group design, patients with a major depressive disorder and a history of violent victimization over the past three years (N = 200) will be allocated to either TAU + iERT (N = 100) or TAU only (N = 100), based on computer-generated stratified block randomization. Assessments will take place at baseline, 8 weeks, 14 weeks, and 6 months after start of treatment, and 12, 24, and 36 months after baseline. The primary outcome measure is the total number of violent victimization incidents at 12 months after baseline, measured with the Safety Monitor: an adequate self-report questionnaire that assesses victimization over the preceding 12 months. Secondary outcome measures and mediators include emotion dysregulation and depressive symptomatology. An economic evaluation with the societal perspective will be performed alongside the trial. DISCUSSION This study is the first to examine the effectiveness of an intervention aimed at reducing violent revictimization in depressed patients. If effective, iERT can be implemented in mental health care, and contribute to the well-being of depressed patients. Furthermore, the results will provide insight into underlying mechanisms of revictimization. TRIAL REGISTRATION The study is registered at the Netherlands Trial Register ( NTR5822 ). Date of registration: 4 April 2016.
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Affiliation(s)
- Carolien Christ
- Department of Psychiatry, VU University Medical Center/ GGZ inGeest, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands. .,Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Marleen M. de Waal
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands ,0000000084992262grid.7177.6Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Digna J. F. van Schaik
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Psychiatry, VU University Medical Center/ GGZ inGeest, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aAmsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Martijn J. Kikkert
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands ,0000000084992262grid.7177.6Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ,0000 0001 0835 8259grid.416017.5Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - Claudi L. H. Bockting
- 0000000120346234grid.5477.1Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, University Utrecht, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Aartjan T. F. Beekman
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Psychiatry, VU University Medical Center/ GGZ inGeest, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aAmsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands ,0000 0004 1754 9227grid.12380.38Department of Clinical Psychology, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, BT 1081 Amsterdam, The Netherlands
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11
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de Waal MM, Dekker JJM, Kikkert MJ, Kleinhesselink MD, Goudriaan AE. Gender differences in characteristics of physical and sexual victimization in patients with dual diagnosis: a cross-sectional study. BMC Psychiatry 2017; 17:270. [PMID: 28743237 PMCID: PMC5526321 DOI: 10.1186/s12888-017-1413-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/30/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Patients with substance use disorders and co-occurring mental health disorders are vulnerable to violent victimization. However, no evidence-based interventions are available to reduce patients' vulnerability. An exploration of the characteristics of physical and sexual violence can provide valuable information to support the development of interventions for these patients. This study aimed to examine gender differences in characteristics of violent victimization in patients with dual diagnosis. METHODS In this cross-sectional survey study recent incidents of physical and sexual assault were examined with the Safety Monitor in 243 patients with dual diagnosis. Chi-square tests were used to examine gender differences in the prevalence of physical and sexual victimization. Fisher's exact tests and Fisher-Freeman-Halton exact tests were used to determine whether there were significant differences between victimized men and women with regard to perpetrators, locations, reporting to the police and speaking about the assault with others. RESULTS There was no significant difference in the prevalence of physical violence in men (35%) and women (47%) with dual diagnosis. There was a significant association between gender of the victim and type of perpetrator (P < .001). Men were most often physically abused by a stranger or an acquaintance, whereas women were most frequently abused by an (ex)partner. Sexual violence was more prevalent in women (29%) compared to men (4%) (P < .001). Patients with dual diagnosis were unlikely to report incidents of physical abuse and sexual assault to the police and to speak about it with caregivers. CONCLUSIONS Characteristics of physical violence are different for men and women with dual diagnosis. Women with dual diagnosis are more often victims of sexual violence compared to men. Interventions aimed at reducing patients' vulnerability for victimization should take gender differences into account.
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Affiliation(s)
- Marleen M. de Waal
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn J. Kikkert
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
| | - Maaike D. Kleinhesselink
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
| | - Anna E. Goudriaan
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands
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12
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Frankenmolen NL, Altgassen M, Kessels R, de Waal MM, Hindriksen JA, Verhoeven B, Fasotti L, Scheres A, Kessels RPC, Oosterman JM. Intelligence moderates the benefits of strategy instructions on memory performance: an adult-lifespan examination. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2016; 24:45-61. [PMID: 27141830 DOI: 10.1080/13825585.2016.1171289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Whether older adults can compensate for their associative memory deficit by using memory strategies efficiently might depend on their general cognitive abilities. This study examined the moderating role of an IQ estimate on the beneficial effects of strategy instructions. A total of 142 participants (aged 18-85 years) received either intentional learning or strategy ("sentence generation") instructions during encoding of word pairs. Whereas young adults with a lower IQ benefited from strategy instructions, those with a higher IQ did not, presumably because they already use strategies spontaneously. Older adults showed the opposite effect: following strategy instructions, older adults with a higher IQ showed a strong increase in memory performance (approximately achieving the level of younger adults), whereas older adults with a lower IQ did not, suggesting that they have difficulties implementing the provided strategies. These results highlight the importance of the role of IQ in compensating for the aging-related memory decline.
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Affiliation(s)
- Nikita L Frankenmolen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Centre Klimmendaal , Arnhem , The Netherlands
| | - Mareike Altgassen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Renée Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Marleen M de Waal
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Julie-Anne Hindriksen
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Barbara Verhoeven
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Luciano Fasotti
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,b Rehabilitation Centre Klimmendaal , Arnhem , The Netherlands
| | - Anouk Scheres
- c Developmental Psychology, Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,d Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Joukje M Oosterman
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
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13
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de Waal MM, Kikkert MJ, Blankers M, Dekker JJM, Goudriaan AE. Self-wise, Other-wise, Streetwise (SOS) training: a novel intervention to reduce victimization in dual diagnosis psychiatric patients with substance use disorders: protocol for a randomized controlled trial. BMC Psychiatry 2015; 15:267. [PMID: 26511799 PMCID: PMC4625454 DOI: 10.1186/s12888-015-0652-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/16/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Psychiatric patients are more likely to be victims of crime than others in the community. Dual diagnosis patients with comorbid psychiatric and substance use disorders are especially prone to victimization. Victimization is associated with substance abuse, more severe symptomatology and homelessness. There is a strong need for interventions to reduce victimization in this population. We developed the Self-wise, Other-wise, Streetwise (SOS) training to reduce victimization in patients with dual diagnosis. METHODS/DESIGN This study is a randomized controlled trial using a parallel group design to determine the effectiveness of adding the SOS training to care as usual. Patients with dual diagnosis (N = 250) will be allocated to either care as usual plus SOS training (N = 125) or care as usual only (N = 125) using computer-generated stratified block randomization. To compare effectiveness participants will be interviewed at baseline and 2, 8 and 14 months follow-up. The primary outcome measure is treatment response (yes/no), defined as either no victimization at 14 months follow-up or at least a 50% reduction in incidents of victimization at 14 months follow-up compared to baseline assessment. Victimization is measured with the Safety Monitor, an adequate self-report instrument used by Statistics Netherlands to measure victimization on a large scale in the Netherlands. Outcome assessors are blind to treatment allocation. An economic evaluation will be performed alongside the randomized controlled trial and will take the societal perspective. DISCUSSION This study is the first randomized controlled trial to examine the effectiveness of an intervention that aims to reduce victimization in patients with dual diagnosis. If the intervention is effective it can be implemented in mental health care and contribute to the safety and well-being of patients. TRIAL REGISTRATION Dutch Trial Register (NTR): 4472, date of registration: 24-03-2014.
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Affiliation(s)
- Marleen M de Waal
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Martijn J Kikkert
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
- Trimbos Institute - Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands.
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Anna E Goudriaan
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
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