Hazardous Substance Use among People with Psychiatric Disabilities Visiting Day Centers

Objective: People who suffer from psychiatric illness have a more than doubled lifetime risk of acquiring an alcohol or drug use disorder. Furthermore, hazardous substance use impairs treatment outcomes and protracts the duration of illness among people with mental disorders. The aim of this study was to investigate substance use among people with psychiatric disabilities receiving municipality-based mental health services, any associations to socio-demographic and well-being variables, to diagnosis or to level of functioning, and any changes at a 15-month follow-up.Methods: One-hundred-and-twenty-three persons with psychiatric disabilities but no diagnosed substance use disorder participated and completed the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) at baseline and the follow-up. Self-report questionnaires were employed to estimate different aspects of well-being in terms of quality of life and self-rated health. Level of functioning and severity of psychiatric symptoms were assessed by the Global Assessment of Functioning (GAF) scale.Results: Nineteen percent of participants had hazardous use of alcohol (14%) or drugs (5%) at baseline, while 23% did not use alcohol and 89% did not use drugs. Since only few participants reported drug use, inferential analyses concentrated on alcohol use. Participants with a foreign origin and lower education were less likely to exhibit alcohol use, including hazardous alcohol use. Sex and age were unrelated to alcohol use, as were the wellbeing variables, level of functioning, symptom severity and self-reported diagnosis. Alcohol and drug use patterns were stable at the follow-up.Conclusion: The findings contribute with knowledge about hazardous substance use among people with psychiatric disabilities and indicate that preventive measures are warranted within the municipality-based mental health services. Staff in the municipality-based mental health services must stay alert on this issue and screening for hazardous use of alcohol and drugs should be considered

The influence of hazardous drinking on psychological functioning, stress and sleep during and after treatment in patients with mental health problems : a secondary analysis of a randomised controlled intervention study

Objectives Hazardous drinking could negatively affect health and lead to alcohol use disorders, but it is unclear how hazardous drinking affects treatment outcomes of depression and anxiety and stress related mental health problems. The aim of this study was to examine whether hazardous drinking, measured by Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), influences the outcomes of repeated assessments of psychological functioning (Outcome Questionnaire-45), stress (Perceived Stress Scale) and sleep (Karolinska Sleep Questionnaire), during and after treatment in patients with mental ill health. Methods The study was conducted within REGASSA, a randomised controlled trial aimed at comparing Internet-based cognitive behaviour therapy and physical exercise with treatment as usual on primary care patients with mental ill health. The study involved 871 participants who completed the AUDIT at baseline and who were assessed repeatedly during and after treatment on psychological functioning, stress and sleep by interactive voice response, a computerised, automated telephone technology. Results At baseline, hazardous drinkers were more depressed and had lower scores on psychological functioning than non-hazardous drinkers, while there were no differences on stress and sleep. During the follow-ups, hazardous drinking negatively influenced perceived stress, that is, hazardous drinkers seemed to have less treatment effect on stress, and the results remained after controlling for depression. There were no differences during the follow-ups regarding psychological functioning and sleep. Conclusions Hazardous drinking negatively influenced perceived stress. The findings of the study emphasise the importance of screening for alcohol habits in mental ill-health patients, since risky drinking may affect the outcomes of treatment

A 6‐Year Follow‐Up of Alcoholics After Long‐Term Outpatient Treatment

The predictors of the long‐term outcome in alcoholics (n= 50) who had been treated in a 2‐year outpatient treatment program were investigated. Previously, the sample had been followed up personally 2 years after the termination of treatment. This study is a repeated, independent follow‐up of the same sample over a 4‐year period, 3–6 years after termination of treatment. Outcome could be categorized in 38 subjects. Patients with a favorable outcome during at least 2 years of the 4‐year follow‐up period (n= 21), who were categorized as a positive outcome group, were compared with the other patients (n= 17). There was no significant correlation between initial patient characteristics and outcome 3–6 years after treatment. Drinking outcome during the 1st half‐year of treatment had no correlation to positive drinking outcome in years 3–6, whereas there was a positive correlation for later phases of treatment and outcome reaching a significant level during the 2nd and 4th half‐year of treatment. A favorable drinking outcome during years 1–2 after treatment had a positive significant correlation to outcome in years 3–6 after treatment [i.e., 80% of the patients with a favorable outcome during the 1st follow‐up period also had a positive outcome during the 2nd follow‐up period, and 72% of those who had an unfavorable outcome during the 1st follow‐up period had an unfavorable outcome also during the 2nd follow‐up period (x2 test = 10.4, p < 0.001). Psycho‐social adjustment at the 6‐year follow‐up did not differ significantly between subjects in the positive outcome group and subjects in the negative outcome group