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Sauceda JA, Lechuga J, Ramos ME, Puentes J, Ludwig-Barron N, Salazar J, Christopoulos KA, Johnson MO, Gomez D, Covarrubias R, Hernandez J, Montelongo D, Ortiz A, Rojas J, Ramos L, Avila I, Gwadz MV, Neilands TB. A factorial experiment grounded in the multiphase optimization strategy to promote viral suppression among people who inject drugs on the Texas-Mexico border: a study protocol. BMC Public Health 2023; 23:307. [PMID: 36765309 PMCID: PMC9921633 DOI: 10.1186/s12889-023-15172-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND People who inject drugs living with HIV (PWIDLH) suffer the lowest rates of HIV viral suppression due to episodic injection drug use and poor mental health coupled with poor retention in HIV care. Approximately 44% of PWIDLH along the US-Mexico border are retained in care and only 24% are virally suppressed. This underserved region faces a potential explosion of transmission of HIV due to highly prevalent injection drug use. This protocol describes an optimization trial to promote sustained viral suppression among Spanish-speaking Latinx PWIDLH. METHODS The multiphase optimization strategy (MOST) is an engineering-inspired framework for designing and building optimized interventions and guides this intervention. The primary aim is to conduct a 24 factorial experiment in which participants are randomized to one of 16 intervention conditions, with each condition comprising a different combination of four behavioral intervention components. The components are peer support for methadone uptake and persistence; behavioral activation therapy for depression; Life-Steps medication adherence counseling; and patient navigation for HIV care. Participants will complete a baseline survey, undergo intervention, and then return for 3-,6-,9-, and 12-month follow-up assessments. The primary outcome is sustained viral suppression, defined as viral loads of < 40 copies per mL at 6-,9-, and 12-month follow-up assessments. Results will yield effect sizes for each component and each additive and interactive combination of components. The research team and partners will make decisions about what constitutes the optimized multi-component intervention by judging the observed effect sizes, interactions, and statistical significance against real-world implementation constraints. The secondary aims are to test mediators and moderators of the component-to-outcome relationship at the 6-month follow-up assessment. DISCUSSION We are testing well-studied and available intervention components to support PWIDLH to reduce drug use and improve their mental health and engagement in HIV care. The intervention design will allow for a better understanding of how these components work in combination and can be optimized for the setting. TRIAL REGISTRATION This project was registered at clinicaltrials.gov (NCT05377463) on May 17th, 2022.
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Affiliation(s)
- John A Sauceda
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, 550 16th Street, 94158, San Francisco, CA, USA.
| | - Julia Lechuga
- College of Health Sciences, Department of Public Health Sciences, University of Texas at El Paso, 1851 Wiggins Rd., 79968, El Paso, TX, USA
| | - Maria Elena Ramos
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - Jorge Puentes
- College of Health Sciences, Department of Public Health Sciences, University of Texas at El Paso, 1851 Wiggins Rd., 79968, El Paso, TX, USA
| | - Natasha Ludwig-Barron
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, 550 16th Street, 94158, San Francisco, CA, USA
| | - Jorge Salazar
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, 996 Potrero Avenue, Building 80, 6th Floor, 94110, San Francisco, CA, USA
| | - Katerina A Christopoulos
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, 996 Potrero Avenue, Building 80, 6th Floor, 94110, San Francisco, CA, USA
| | - Mallory O Johnson
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, 550 16th Street, 94158, San Francisco, CA, USA
| | - David Gomez
- Centro de Integración Juvenil (CIJ), Cuidad Juárez, Blvd Ing Bernardo Norzagaray, 32130, Cazatecas, Chihuahua, México
| | - Rogelio Covarrubias
- Centro Ambulatorio para la prevención y Atención de SIDA y de las Enfermedades de Transmisión Sexual (CAPASITS), Cuidad Juárez, Avenue Paseo Triunfo de la Republica 3530, 32330, Partido Escobedo, Chihuahua, México
| | - Joselyn Hernandez
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - David Montelongo
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - Alejandro Ortiz
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - Julian Rojas
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - Luisa Ramos
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - Itzia Avila
- Program Compañeros, Cuidad Juárez, Avenue de la Raza 2661, Silvias, Chihuahua, México
| | - Marya V Gwadz
- Silver School of Social Work, New York University, 1 Washington Square N, 10003, New York, NY, USA
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, 550 16th Street, 94158, San Francisco, CA, USA
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Pott SL, Kellett SC, Green S, Daughters S, Delgadillo J. Behavioral activation for depression delivered by drug and alcohol treatment workers: A pilot randomized controlled trial. J Subst Abuse Treat 2022; 139:108769. [DOI: 10.1016/j.jsat.2022.108769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/10/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
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Le SM, Trouiller P, Duong TH, Khuat THO, Pham MK, Vallo R, Rapoud D, Quillet C, Nguyen TL, Nguyen QD, Nham TTT, Hoang TG, Feelemyer J, Vu HV, Moles JP, Doan HQ, Laureillard D, Des Jarlais DC, Nagot N, Michel L. Development and assessment of a community-based screening tool for mental health disorders among people who inject drugs. Drug Alcohol Rev 2022; 41:697-705. [PMID: 34786755 PMCID: PMC10150937 DOI: 10.1111/dar.13402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The prevalence of mental health disorders among people who use drugs is high and well documented. This hard-to-reach population faces a very low awareness and access to mental health care, especially in developing countries. The objectives of this study were to design and assess a quick screening tool (QST) that community-based organisations (CBO) could routinely apply to a Vietnamese population of people who inject drugs (PWID), in order to refer them appropriately to mental health specialists. METHODS We devised a tool that included nine questions covering anxiety, depression, suicide risk and psychotic symptomatology. Its use required no specific background and 2 h training. Specificity and sensitivity of the QST were assessed in a population of 418 PWID recruited via respondent driven sampling, using the Mini International Neuropsychiatric Interview questionnaire plus clinical evaluation as a reference standard. Acceptability was assessed using a self-administered anonymous questionnaire submitted to all CBO members who used the QST. RESULTS CBO members considered the QST easy to use, relevant and helpful to deal with mental health issues. Area under the curve for detection of any symptom using the QST was 0.770. The maximum sensitivity and specificity were reached with a cut-off of 2 [sensitivity was 71.1% (95% confidence interval 62.4, 78.8), specificity was 75.9% (70.5, 80.7)]. DISCUSSION AND CONCLUSIONS The QST appeared to be both efficient and well accepted. Given the burden of mental health problems among hard-to-reach PWID in developing countries, community-based screenings such as this one could be a particularly appropriate response.
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Affiliation(s)
- Sao M Le
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Philippe Trouiller
- CESP Inserm UMRS 1018, Paris Saclay University, Pierre Nicole Center, French Red Cross, Paris, France
| | - Thi H Duong
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Thi H O Khuat
- Supporting Community Development Initiatives, Hanoi, Vietnam
| | - Minh K Pham
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Roselyne Vallo
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Delphine Rapoud
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Catherine Quillet
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Thuy L Nguyen
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Quang D Nguyen
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | | | - Thi G Hoang
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | | | - Hai V Vu
- Department of Infectious and Tropical Diseases, Viet Tiep Hospital, Hai Phong, Vietnam
| | - Jean-Pierre Moles
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Hong Q Doan
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Didier Laureillard
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
- Infectious Diseases Department, Caremeau University Hospital, Place du Professeur Robert Debré, Nîmes, France
| | | | - Nicolas Nagot
- Pathogenesis and Control of Chronic Infections, Inserm, Etablissement Français du Sang, University of Montpellier, Montpellier, France
| | - Laurent Michel
- CESP Inserm UMRS 1018, Paris Saclay University, Pierre Nicole Center, French Red Cross, Paris, France
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Lien IA, Bolstad I, Lien L, Bramness JG. Screening for depression in patients in treatment for alcohol use disorder using the Beck Depression Inventory-II and the Hopkins Symptom Checklist-10. Psychiatry Res 2022; 308:114363. [PMID: 34979381 DOI: 10.1016/j.psychres.2021.114363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/20/2022]
Abstract
Alcohol use disorder (AUD) and major depressive disorder (MDD) are prevalent disorders that often co-occur. The aim of the study was to investigate how the Beck Depression Inventory (BDI-II) and Hopkins Symptom Checklist (HSCL-10) perform as screening instruments for MDD in AUD patients in treatment. The study included 127 mainly AUD inpatients currently in treatment at rehabilitation clinics in Norway. Demographic and clinical variables were examined using questionnaires and clinical interviews. The factor structures of the BDI-II and HCSL-10 were examined, as well as internal consistency and receiver operating characteristic (ROC) curve analyses. The Mini International Neuropsychiatric Interview (M.I.N.I.) was used as standard for diagnosing MDD. In total, 14% of the participants were diagnosed with MDD. BDI-II factor analysis retrieved three factors; cognition, somatic complaints and affect, and factor analysis for the HSCL-10 retrieved two factors; depression and anxiety. The optimal cut-off for the BDI-II was 24.5 with sensitivity of 80% and specificity of 78%. For HSCL-10 the optimal cut-off was 2.35, giving sensitivity of 80% and specificity of 69%. Both the BDI-II and HSCL-10 may be clinically useful screening instruments for MDD in AUD patients. There was a tendency that the affect factor of the BDI-II and the depression factor of the HSCL-10 were slightly more suitable for identifying MDD than the other factors. Optimal cut-offs for both the BDI-II and the HSCL-10 in this patient group were higher than cut-offs commonly used in the general population.
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Affiliation(s)
| | - Ingeborg Bolstad
- National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway; Faculty of Social and Health Sciences, Inland University of Applied Sciences, Hamar, Norway
| | - Lars Lien
- National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway; Faculty of Social and Health Sciences, Inland University of Applied Sciences, Hamar, Norway.
| | - Jørgen G Bramness
- National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway; Norwegian Institute of Public Health, Oslo, Norway; Institute of Clinical Medicine, University of Tromsø, - The Arctic University of Norway, Tromsø, Norway
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Is behavioral activation an effective and acceptable treatment for co-occurring depression and substance use disorders? A meta-analysis of randomized controlled trials. J Subst Abuse Treat 2021; 132:108478. [PMID: 34146994 DOI: 10.1016/j.jsat.2021.108478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/28/2020] [Accepted: 05/11/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Depression often co-occurs with substance use problems and is associated with poor treatment outcomes. While the efficacy of behavioral activation (BA) has been tested in clinical trials with substance users, outcomes have not yet been quantitatively synthesized. METHODS The study team performed a random effects meta-analysis of the randomized clinical trial evidence base. We compared outcomes for individual or group BA against passive or active controls. We also compared attendance and dropout rates. The meta-analysis used a grading of recommendations assessment, development, and evaluation (GRADE) approach to assess the quality of each meta-analytic comparison. RESULTS We included five trials in the meta-analysis (N = 195). The analysis found no significant differences between BA and controls with regard to depression (Post-treatment: k = 5; N = 195; SMD: 0.19, CI -0.10 to 0.49; p = 0.20; GRADE = Low; Follow-up: k = 5; N = 195; SMD: -0.10, CI -0.51 to -0.30; p = 0.62; GRADE = Low) or substance use (post-treatment: k = 4; N = 151; SMD: 0.14, CI -0.33 to -0.6; p = 0.57, GRADE = Low; Follow-up: k = 4; N = 151; SMD: 0.17, CI -0.34 to 0.69; p = 0.51, GRADE = Low) and there was little evidence of publication bias. The average session attendance rate for BA was 72%. An average dropout rate of 35% was reported for both BA and comparator conditions. CONCLUSION BA does not emerge as a differentially efficacious treatment for comorbid depression and substance use disorders, although it does appear to be an acceptable treatment option. Our confidence in the results are limited by the number and quality of the original studies and the possibility of the effect of small study bias. We make suggestions for improving the methodological quality and direction of future BA trials.
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Southey MM, Rees T, Rolfe M, Pit S. An evaluation of the maintenance to abstinence (MTA) program in achieving abstinence in opioid users and improving mental health and quality of life. Addict Sci Clin Pract 2019; 14:4. [PMID: 30717808 PMCID: PMC6360677 DOI: 10.1186/s13722-019-0132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Residential opioid rehabilitation aims to improve the mental health and quality of life of opioid users through abstinence and residential program participation. This study aimed to determine the depression, anxiety, stress and quality of life amongst maintenance to abstinence (MTA) program residents. Secondary study aims were to assess the personal characteristics of MTA clients, addiction and risk taking behaviours, factors associated with program completion, as well as to assess the reliable change in participants' mental health and quality of life on exit. METHODS Retrospective analysis of routinely collected data (2013-2017) from surveys completed by 100 clients. Outcome measures were: Depression, Anxiety, Stress Score (DASS-42), World Health Organisation Quality of Life 8 questions (WHOQOL-8) and Kessler Psychological Distress Scale (K10). Other variables included demographics, drug use, other addictions, aggression, self-harm, suicidal ideation/attempts, and risk taking behaviours. Statistical methods included Chi-square, Fisher's exact, t-tests, repeated measures analysis of variance and the Reliable Change Index. RESULTS All mean DASS-42, WHOQOL-8 and K10 scores improved significantly in all participants from entry to exit (p < 0.001). The majority of participants demonstrated reliable improvement across all psychometric measures. Completion rates for the MTA program were 51%. Depression (p = 0.023), anxiety (p = 0.010) and stress (p = 0.015) DASS-42 scores decreased significantly more in completers compared to non-completers. The rate of improvement in mean WHOQOL-8 scores and psychological distress scores (K10) was not statistically significantly different between completers and non-completers over time. There was no significant difference between completers and non-completers on socio-demographics, self-reported drug addiction or risk taking behaviour on program entry, except for suicidal thoughts while intoxicated (p = 0.033). Completers were more satisfied with their relationships (p = 0.044) and living place (p = 0.040) on program entry. CONCLUSION Overall, completers and non-completers demonstrated improved mental health and quality of life from entry to exit, regardless of program completion. Depression, anxiety and stress reduced more markedly in program completers. Policy makers and programmers could use these findings to further validate their own programs to improve mental health and quality of life of opioid users.
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Affiliation(s)
| | - Trent Rees
- The Buttery, Binna Burra, QLD, Australia
| | - Margaret Rolfe
- University of Sydney, Sydney, NSW, Australia.,University Centre for Rural Health, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Sabrina Pit
- Western Sydney University, Sydney, NSW, Australia. .,University of Sydney, Sydney, NSW, Australia. .,University Centre for Rural Health, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia. .,Western Sydney University School of Medicine, Campbelltown, NSW, Australia.
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Win KL, Kawakami N, Htet Doe G. Factor structure and diagnostic efficiency of the Myanmar version BDI-II among substance users. Ann Gen Psychiatry 2019; 18:12. [PMID: 31367222 PMCID: PMC6647319 DOI: 10.1186/s12991-019-0236-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 07/09/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Beck Depression Inventory II (BDI-II) has been accepted as one of the most commonly used self-report measures for depression. However, there is no study examining the psychometric properties of the BDI-II among substance users in low- and middle-income countries such as Myanmar. Therefore, this study aimed to evaluate the suitability of using this instrument in substance users and to examine the reliability and diagnostic efficiency to be compared with the International Classification of Diseases (ICD-10) among substance users in Northern Shan State of Myanmar. METHODS A respondent-driven sampling (RDS) method was applied for recruiting the participants in this study, and total 230 substance users were recruited. On the other hand, 50 participants who visited the drop-in center (DIC) were screened for depressive symptoms using ICD-10 during the days when one consultant psychiatrist doctor was presented. These participants were interviewed face-to-face by the consultant psychiatrist using a semi-structured questionnaire including the Myanmar version of the BDI-II (mBDI-II). RESULTS The mBDI-II showed moderate accuracy with an area under the curve of 0.68. The optimal cutoff score was 10 with the highest Youden index (0.48), and it had high sensitivity and specificity (0.78 and 0.70). The Cronbach's alpha coefficients for clinically depressed and non-clinically depressed substance users were 0.91 and 0.93, respectively. Confirmatory factor analysis of the mBDI-II indicated that a three-factor solution (cognitive, affective, and somatic) was the best fit for substance users. CONCLUSIONS The mBDI-II has sound psychometric properties among substance users with moderate accuracy and range of possible cutoff scores together with sensitivity and specificity.
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Affiliation(s)
- Khine Lae Win
- 1Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Norito Kawakami
- 1Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Gyaw Htet Doe
- Department of Psychiatry and Mental Health, Defense Services Medical Academy, Mingaladon Township, Yangon, 11021 Myanmar
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Akiyama MJ, Agyemang L, Arnsten JH, Heo M, Norton BL, Schackman BR, Linas BP, Litwin AH. Rationale, design, and methodology of a trial evaluating three models of care for HCV treatment among injection drug users on opioid agonist therapy. BMC Infect Dis 2018; 18:74. [PMID: 29426304 PMCID: PMC5807730 DOI: 10.1186/s12879-018-2964-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/16/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND People who inject drugs (PWID) constitute 60% of the approximately 5 million people in the U.S. infected with hepatitis C virus (HCV). Treatment of PWID is complex due to addiction, mental illness, poverty, homelessness, lack of positive social support, poor adherence-related skills, low motivation and knowledge, and poor access to and trust in the health care system. New direct-acting antiviral medications are available for HCV with high cure rates and few side effects. The life expectancy and economic benefits of new HCV treatments will not be realized unless we determine optimal models of care for the majority of HCV-infected patients. The purpose of this study is to evaluate the effectiveness of directly observed therapy and group treatment compared with self-administered individual treatment in a large, urban opioid agonist therapy clinic setting in the Bronx, New York. METHODS/DESIGN In this randomized controlled trial 150 PWID with chronic HCV were recruited from opioid agonist treatment (OAT) clinics and randomized to one of three models of onsite HCV treatment in OAT: 1) modified directly observed therapy; 2) group treatment; or 3) control - self-administered individual treatment. Participants were age 18 or older, HCV genotype 1, English or Spanish speaking, treatment naïve (or treatment experienced after 12/3/14), willing to receive HCV treatment onsite, receiving methadone or buprenorphine at the medication window at least once per week, and able to provide informed consent. Outcomes of interest include adherence (as measured by self-report and electronic blister packs), HCV treatment completion, sustained virologic response, drug resistance, and cost-effectiveness. DISCUSSION This paper describes the design and rationale of a randomized controlled trial comparing three models of care for HCV therapy delivered in an opioid agonist treatment program. Our trial will be critical to rigorously identify models of care that result in high adherence and cure rates. Use of blister pack technology will help us determine the role of adherence in successful cure of HCV. Moreover, the trial methodology outlined here can serve as a template for the development of future programs and studies among HCV-infected drug users receiving opioid agonist therapy, as well as the cost-effectiveness of such programs. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov ( NCT01857245 ). Trial registration was obtained prospectively on May 20th, 2013.
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Affiliation(s)
- Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Linda Agyemang
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Julia H. Arnsten
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Moonseong Heo
- Department of Epidemiology and Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Brianna L. Norton
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Bruce R. Schackman
- Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, NY USA
| | - Benjamin P. Linas
- Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
| | - Alain H. Litwin
- Department of Medicine, University of South Carolina School of Medicine–Greenville, Greenville, South Carolina USA
- Department of Medicine, Greenville Health System, Greenville, South Carolina USA
- Department of Medicine, Clemson University School of Health Research, Clemson, South Carolina USA
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Strunk KK, Lane FC. The Beck Depression Inventory, Second Edition (BDI-II). MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2016. [DOI: 10.1177/0748175616664010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Moore AA, Neale MC, Silberg JL, Verhulst B. Substance Use and Depression Symptomatology: Measurement Invariance of the Beck Depression Inventory (BDI-II) among Non-Users and Frequent-Users of Alcohol, Nicotine and Cannabis. PLoS One 2016; 11:e0152118. [PMID: 27046165 PMCID: PMC4821457 DOI: 10.1371/journal.pone.0152118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 03/09/2016] [Indexed: 11/19/2022] Open
Abstract
Depression is a highly heterogeneous condition, and identifying how symptoms present in various groups may greatly increase our understanding of its etiology. Importantly, Major Depressive Disorder is strongly linked with Substance Use Disorders, which may ameliorate or exacerbate specific depression symptoms. It is therefore quite plausible that depression may present with different symptom profiles depending on an individual’s substance use status. Given these observations, it is important to examine the underlying construct of depression in groups of substance users compared to non-users. In this study we use a non-clinical sample to examine the measurement structure of the Beck Depression Inventory (BDI-II) in non-users and frequent-users of various substances. Specifically, measurement invariance was examined across those who do vs. do not use alcohol, nicotine, and cannabis. Results indicate strict factorial invariance across non-users and frequent-users of alcohol and cannabis, and metric invariance across non-users and frequent-users of nicotine. This implies that the factor structure of the BDI-II is similar across all substance use groups
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Affiliation(s)
- Ashlee A. Moore
- Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, United States of America
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States of America
- * E-mail:
| | - Michael C. Neale
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States of America
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Judy L. Silberg
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States of America
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Brad Verhulst
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America
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Abstract
Two meta-analyses examined the factor structure of the Beck Depression Inventory-II (BDI-II). Study 1, which meta-analyzed 51 studies comprising 62 samples (N = 20,475) providing pattern matrices, determined that the two-factor solution comprising Cognitive and Somatic-Affective factors was supported for the full sample. The two-factor solution was also supported for subgroups of studies. As the factor structure varied somewhat between subgroups of studies, the strength of relationships between scale items and their underlying depressive symptoms varied. Hence, comparisons of mean BDI-II scores across subgroups can be misleading. Study 2 meta-analyzed 13 studies consisting of 16 samples (N = 5,128) providing covariance matrices among the 21 BDI-II items. The two-factor solution was again supported in Study 2. Nevertheless, the existence of a general depression factor was supported by the good fit of the one-factor model.
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Skule C, Ulleberg P, Dallavara Lending H, Berge T, Egeland J, Brennen T, Landrø NI. Depressive symptoms in people with and without alcohol abuse: factor structure and measurement invariance of the Beck Depression Inventory (BDI-II) across groups. PLoS One 2014; 9:e88321. [PMID: 24533075 PMCID: PMC3922762 DOI: 10.1371/journal.pone.0088321] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 01/11/2014] [Indexed: 12/02/2022] Open
Abstract
This study explored differences in the factor structure of depressive symptoms in patients with and without alcohol abuse, and differences in the severity of depressive symptoms between the two groups. In a sample of 358 patients without alcohol problems and 167 patients with comorbid alcohol problems, confirmatory factor analysis revealed that the same factor structures, Beck et al.'s two-factor Somatic Affective-Cognitive (SA-C) model, and Buckley et al.'s three-factor Cognitive-Affective- Somatic (C-A-S) model, demonstrated the best fit to the data in both groups. The SA-C model was preferred due to its more parsimonious nature. Evidence for strict measurement invariance across the two groups for the SA-C model was found. MIMIC (multiple-indicator-multiple-cause) modeling showed that the level of depressive symptoms was found to be highest on both factors in the group with comorbid alcohol problems. The magnitude of the differences in latent mean scores suggested a moderate difference in the level of depressive symptoms between the two groups. It is argued that patients with comorbid depression and alcohol abuse should be offered parallel and adequate treatment for both conditions.
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Affiliation(s)
- Cecilie Skule
- Community Mental Health Center Vinderen, Diakonhjemmet Hospital, Oslo, Norway
| | - Pål Ulleberg
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Torkil Berge
- Community Mental Health Center Vinderen, Diakonhjemmet Hospital, Oslo, Norway
| | - Jens Egeland
- Department of Psychology, University of Oslo, Oslo, Norway
- Vestfold Mental Health Care Trust, Tønsberg, Norway
| | - Tim Brennen
- Department of Psychology, University of Oslo, Oslo, Norway
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Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:416-31. [DOI: 10.1590/1516-4446-2012-1048] [Citation(s) in RCA: 655] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 02/13/2013] [Indexed: 02/05/2023]
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14
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Changes in the Beck Depression Inventory-II's underlying symptom structure over 1 month of inpatient treatment. J Nerv Ment Dis 2013; 201:371-6. [PMID: 23588226 DOI: 10.1097/nmd.0b013e31828e1004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research has not investigated changes in the symptom structure of depression over the course of mental health treatment. In the present study, 1025 psychiatric inpatients were recruited and assessed for depression symptom severity using the Beck Depression Inventory-II (BDI-II) at admission and after 1 month of treatment. A three-factor BDI-II model was tested using confirmatory factor analysis and fit reasonably well at both time points. Measurement invariance testing results demonstrated that factor loadings increased, indicating that the meaning of the three underlying depression dimensions changed through treatment. However, observed variable intercepts and residual error variances decreased significantly after 1 month of treatment, reflecting decreases in symptom severity as well as measurement error. Thus, depressive symptom severity decreased over the course of treatment, and the underlying factor structure of depression improved in fit after treatment. Implications for changes to the structure of depression symptoms and in the clinical practice of tracking depression over time are discussed.
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Dhingra L, Masson C, Perlman DC, Seewald RM, Katz J, McKnight C, Homel P, Wald E, Jordan AE, Young C, Portenoy RK. Epidemiology of pain among outpatients in methadone maintenance treatment programs. Drug Alcohol Depend 2013; 128:161-5. [PMID: 22951068 PMCID: PMC3546120 DOI: 10.1016/j.drugalcdep.2012.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 08/01/2012] [Accepted: 08/03/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND This analysis explored the prevalence and correlates of pain in patients enrolled in methadone maintenance treatment (MMT). METHODS Patients in two MMT programs starting a hepatitis care coordination randomized controlled trial completed the Brief Pain Inventory Short-Form and other questionnaires. Associations between clinically significant pain (average daily pain≥5 or mean pain interference≥5 during the past week) and sociodemographic data, medical status, depressive symptoms, and health-related quality of life, and current substance use were evaluated in multivariate analyses. RESULTS The 489 patients included 31.8% women; 30.3% Hispanics, 29.4% non-Hispanic Blacks, and 36.0% non-Hispanic Whites; 60.1% had hepatitis C, 10.6% had HIV, and 46.8% had moderate or severe depressive symptomatology. Mean methadone dose was 95.7mg (SD 48.9) and urine drug screening (UDS) was positive for opiates, cocaine, and amphetamines in 32.9%, 40.1%, and 2.9%, respectively. Overall, 237 (48.5%) reported clinically significant pain. Pain treatments included prescribed opioids (38.8%) and non-opioids (48.9%), and self-management approaches (60.8%), including prayer (33.8%), vitamins (29.5%), and distraction (12.7%). Pain was associated with higher methadone dose, more medical comorbidities, prescribed opioid therapy, and more severe depressive symptomatology; it was not associated with UDS or self-reported substance use. CONCLUSIONS Clinically significant pain was reported by almost half of the patients in MMT programs and was associated with medical and psychological comorbidity. Pain was often treated with opioids and was not associated with measures of drug use. Studies are needed to further clarify these associations and determine their importance for pain treatment strategies.
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Affiliation(s)
- Lara Dhingra
- Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, USA.
| | - Carmen Masson
- Department of Psychiatry, University of California at San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110
| | - David C. Perlman
- Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003
,Department of Medicine, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003
,Center for Drug Use and HIV Research, New York University College of Nursing, 726 Broadway, New York, NY 10003
| | - Randy M. Seewald
- Department of Medicine, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003
| | - Judith Katz
- New York University School of Medicine, 550 First Avenue, New York, NY 10016
| | - Courtney McKnight
- Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003
,Center for Drug Use and HIV Research, New York University College of Nursing, 726 Broadway, New York, NY 10003
| | - Peter Homel
- Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219
| | - Emily Wald
- Columbia Teacher’s College, 525 West 120th Street, New York, NY 10027
| | - Ashly E. Jordan
- Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003
| | - Christopher Young
- Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003
| | - Russell K. Portenoy
- Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, Departments of Anesthesiology and Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461
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Liles BD, Newman E, LaGasse LL, Derauf C, Shah R, Smith LM, Arria AM, Huestis MA, Haning W, Strauss A, DellaGrotta S, Dansereau LM, Neal C, Lester BM. Perceived child behavior problems, parenting stress, and maternal depressive symptoms among prenatal methamphetamine users. Child Psychiatry Hum Dev 2012; 43:943-57. [PMID: 22552952 PMCID: PMC3717339 DOI: 10.1007/s10578-012-0305-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study was designed to examine parenting stress, maternal depressive symptoms, and perceived child behavior problems among mothers who used methamphetamine (MA) during pregnancy. Participants were a subsample (n = 212; 75 exposed, 137 comparison) of biological mothers who had continuous custody of their child from birth to 36 months. The subsample was drawn from a larger, ongoing longitudinal study on the effects of prenatal methamphetamine exposure (n = 412; 204 exposed, 208 comparison) (Arria et al in Matern Child Health J 10:293-302 2006). Mothers who used MA during pregnancy reported more parenting stress and more depressive symptoms than a matched comparison group. There were no differences between groups on perceived child behavior problems. In a hierarchical linear model, depressive symptoms, and perceived child behavior problems, but not MA exposure, were statistically significant predictors of parenting stress. Screening for potential parenting problems among mothers with a history of substance abuse is warranted. Parenting interventions targeting depressive symptoms, parenting stress, and child behavior problems are needed for this population.
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Affiliation(s)
- Brandi D. Liles
- Department of Psychology, University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104-3189, USA
| | - Elana Newman
- Department of Psychology, University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104-3189, USA
| | - Linda L. LaGasse
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Chris Derauf
- Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rizwan Shah
- Blank Hospital, Regional Child Protection Center-Children-Iowa Health, Des Moines, IA, USA
| | - Lynne M. Smith
- LABioMed Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Amelia M. Arria
- Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD, USA
| | - Marilyn A. Huestis
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - William Haning
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Arthur Strauss
- Miller Children’s Hospital at Long Beach (MCHLB), Long Beach, CA, USA
| | - Sheri DellaGrotta
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Lynne M. Dansereau
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Charles Neal
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Barry M. Lester
- Center for the Study of Children at Risk, Women and Infant’s Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Rumination Mediates the Relationship Between Distress Tolerance and Depressive Symptoms Among Substance Users. COGNITIVE THERAPY AND RESEARCH 2012; 37:456-465. [PMID: 23729916 DOI: 10.1007/s10608-012-9488-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Distress tolerance has been implicated in the emergence of internalizing symptomatology, notably depressive symptoms. However, few studies have tested potential mechanisms underlying the relationship between distress tolerance and depressive symptoms, and further, this has not been tested among substance users, who commonly experience both low distress tolerance and elevated depressive symptoms. The current study focused on the construct of rumination, which has been suggested to be a coping response to stress associated with substance use and depression. Two forms of rumination, brooding and reflection, were tested as potential mediators of the relationship between distress tolerance and self-reported depressive symptoms among 128 individuals entering substance abuse treatment. Brooding (i.e., to overly focus on symptoms of distress) mediated the relationship between distress tolerance and depressive symptoms. However, reflection (i.e., to attempt to gain insight into problems) was unrelated to distress tolerance. Findings suggest the important role of brooding as a mechanism underlying the relationship between distress tolerance and depressive symptomatology.
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Titov N, Dear BF, McMillan D, Anderson T, Zou J, Sunderland M. Psychometric Comparison of the PHQ-9 and BDI-II for Measuring Response during Treatment of Depression. Cogn Behav Ther 2011; 40:126-36. [DOI: 10.1080/16506073.2010.550059] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Examining the effect of the Life Enhancement Treatment for Substance Use (LETS ACT) on residential substance abuse treatment retention. Addict Behav 2011; 36:615-623. [PMID: 21310539 DOI: 10.1016/j.addbeh.2011.01.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 12/30/2010] [Accepted: 01/11/2011] [Indexed: 11/22/2022]
Abstract
Effective, parsimonious behavioral interventions that target reinforcement are needed for substance users with depression to improve mood as well as treatment retention. The Life Enhancement Treatment for Substance Use (LETS ACT; Daughters et al., 2008) is a behavioral activation-based approach tailored to increase levels of positive reinforcement among depressed substance users while in substance abuse treatment. The current study tested the efficacy of LETS ACT compared to a contact-time matched control condition, supportive counseling (SC), examining effects on depressed mood, substance abuse treatment retention, and behavioral activation outcomes. Fifty-eight adult substance users in residential substance abuse treatment presenting with depressive symptoms (BDI≥12) were randomly assigned to LETS ACT or SC. Assessments were administered at pre- and post-treatment and included assessment of DSM-IV psychiatric diagnoses, depression severity, treatment motivation, overall activation, environmental reward, and substance abuse treatment retention. Patients in LETS ACT had significantly higher rates of substance abuse treatment retention and significantly greater increases in activation on the Behavioral Activation for Depression Scale (BADS) compared to those in SC. Both groups had decreased depression severity at post-treatment, although the group by time interaction was not significant. This study was the first to compare LETS ACT to a contact-time matched control treatment to evaluate effects on substance abuse treatment retention and two distinct measures of behavioral activation: overall activation and environmental reward. Findings suggest preliminary support for the feasibility, tolerability, and efficacy of a brief behavioral activation-based protocol that may be particularly useful to improve substance abuse treatment retention.
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20
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Lemstra M, Rogers M, Thompson A, Moraros J, Buckingham R. Risk indicators of depressive symptomatology among injection drug users and increased HIV risk behaviour. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:358-66. [PMID: 21756450 DOI: 10.1177/070674371105600607] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES In 2009, the annual incidence of positive human immunodeficiency virus (HIV) test reports for people in the Saskatoon Health Region (SHR) was 31.3 per 100,000, when the national average was only 9.3 per 100 000. The first objective was to determine the prevalence of depressive symptomatology among injection drug users (IDUs) in the SHR. The second objective was to determine the unadjusted and adjusted risk indicators associated with depressive symptomatology among IDUs. The third objective was to determine if depressive symptomatology was associated with HIV risk behaviours. METHODS From September 2009 to April 2010, 603 current IDUs were surveyed with validated instruments; this sample represents 76.6% of known IDUs in the SHR. RESULTS Among the respondents, 81.4% reported depressive symptomatology, whereas 57.7% reported more severe depressive symptomatology. After multivariate analysis, the 4 covariates that had an independent association with depressive symptomatology included sexual assault as an adult, sexual assault as a child, attending a residential school, and having an annual income of less than $10,000 Depressive symptomatology was initially associated with 7 HIV risk behaviours. After multivariate analysis, depressive symptomatology was associated with giving sex to get money, giving drugs to get sex, and with more frequently sharing injecting equipment. CONCLUSIONS This study found that depressive symptomatology was strongly associated with injection drug use.
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Affiliation(s)
- Mark Lemstra
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan.
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21
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Schuman-Olivier Z, Albanese M, Nelson SE, Roland L, Puopolo F, Klinker L, Shaffer HJ. Self-treatment: illicit buprenorphine use by opioid-dependent treatment seekers. J Subst Abuse Treat 2010; 39:41-50. [PMID: 20434868 DOI: 10.1016/j.jsat.2010.03.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 03/08/2010] [Accepted: 03/22/2010] [Indexed: 11/17/2022]
Abstract
Outpatient-based opioid treatment (OBOT) with buprenorphine is an important treatment for people with opioid dependence. No quantitative empirical research has examined rationales for use of illicit buprenorphine by U.S. opioid-dependent treatment seekers. The current study sequentially screened OBOT admissions (n = 129) during a 6-month period in 2009. This study had two stages: (a) a cross-sectional epidemiological analysis of new intakes and existing patients already receiving a legal OBOT prescription (n = 78) and (b) a prospective longitudinal cohort design that followed 76% of the initial participants for 3 months of treatment (n = 42). The primary aims were to establish 2009 prevalence rates for illicit buprenorphine use among people seeking OBOT treatment, to use quantitative methods to investigate reasons for this illicit use, and to examine the effect of OBOT treatment on illicit buprenorphine use behavior. These data demonstrate a decrease in illicit use when opioid-dependent treatment seekers gain access to legal prescriptions. These data also suggest that the use of illicit buprenorphine rarely represents an attempt to attain euphoria. Rather, illicit use is associated with attempted self-treatment of symptoms of opioid dependence, pain, and depression.
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Affiliation(s)
- Zev Schuman-Olivier
- Cambridge Health Alliance, Department of Psychiatry, Harvard Medical School, United States.
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22
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McPherson A, Martin CR. A narrative review of the Beck Depression Inventory (BDI) and implications for its use in an alcohol-dependent population. J Psychiatr Ment Health Nurs 2010; 17:19-30. [PMID: 20100303 DOI: 10.1111/j.1365-2850.2009.01469.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The findings from the present study reveal that the Beck Depression Inventory (BDI) is a reliable and valid instrument for measuring depression in a variety of populations. This realization should enable nurses and other health professionals to utilize the tool with added confidence and assurance. * The main finding was that the BDI would probably be a reliable and valid screening tool in an alcohol-dependent population. This conclusion appears to echo the relationship that alcohol consumption generally has with depression. This finding is important to those practitioners using the BDI in this population in that it provides further evidence to enhance their practical experience. Abstract A psychometric evaluation of the Beck Depression Inventory (BDI) was carried out on contemporary studies to ascertain its suitability for use in an alcohol-dependent population. Three criteria were used for this: factor analysis, test-retest reliability and internal consistency reliability. Factor analysis revealed that its structure is consistent with either two or three factor models, depending on the population. Test-retest results concluded that the correlation coefficient remained above the recommended threshold and internal consistency reliability highlighted alpha coefficient results consistently above suggested scores, leading to the conclusion that the BDI is probably an effective screening tool in an alcohol-dependent population.
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Affiliation(s)
- A McPherson
- Postgraduate Research Student, School of Health, Nursing and Midwifery, University of the West of Scotland, Ayr, UK
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23
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Jackson DO, Cropsey KL, Weaver MF, Villalobos GC, Eldridge G, Stitzer ML. Factors related to injection drug use among female prisoners. Subst Use Misuse 2010; 45:368-83. [PMID: 20141453 DOI: 10.3109/10826080903452454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Female inmates (N = 655) of a large prison facility in the southeastern United States were surveyed about their substance use, social histories, and demographics. Multinomial logistic regression was used to identify predictors of injection drug use. The sample was primarily young (M = 34 +/- 9 years), and evenly split on race (45.3% White and 44.6% Black). Four predictors were identified as significant risk factors for injection drug use: being White, having a prior history of substance user treatment, having a prior drug-related charge, and being a problem drinker. Implications, limitations, and future directions are discussed.
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Perry AE, Olason DT. A new psychometric instrument assessing vulnerability to risk of suicide and self-harm behaviour in offenders: Suicide Concerns for Offenders in Prison Environment (SCOPE). INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2009; 53:385-400. [PMID: 18519741 DOI: 10.1177/0306624x08319418] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study aimed to develop a new psychometric instrument to assess vulnerability to risk of suicide and nonfatal self-harm behaviour in young adult male and female offenders. In total three studies were conducted to assess the psychometric properties of the new instrument using both exploratory and confirmatory factor analysis in different samples. Participants in all three studies included a total of 1,166 young adult offenders across six Her Majesty's Prisons. The new instrument, Suicide Concerns for Offenders in Prison Environment (SCOPE), contained 28 items scoring on two subscales. The factorial structure of the new instrument initially obtained with exploratory factor analysis was subsequently confirmed in a new sample. The internal consistency of the two subscales were acceptable but the test-retest reliability coefficients were moderate. Concurrent validation with the Beck Hopelessness Scale was acceptable and SCOPE showed the ability to discriminate between those at risk and those with no known history of attempted suicide and nonfatal self-harm behaviour ( p < 0.01).
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Hepner KA, Hunter SB, Edelen MO, Zhou AJ, Watkins K. A comparison of two depressive symptomatology measures in residential substance abuse treatment clients. J Subst Abuse Treat 2009; 37:318-25. [PMID: 19359127 DOI: 10.1016/j.jsat.2009.03.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 03/03/2009] [Indexed: 11/18/2022]
Abstract
Comorbid depression is common among substance abusers, making routine assessment of depression critical for high-quality care. We evaluated two of the most commonly used depressive symptomatology measures in a sample of clients (N = 240) in residential substance abuse treatment settings. The Beck Depression Inventory (BDI-II) has previously been used in clients receiving substance abuse treatment. The Patient Health Questionnaire (PHQ-9), originally developed for primary care settings, has not been used as frequently in substance abuse treatment settings, and it is unknown how it performs in this population. The measures were highly correlated with each other (r = .76) and demonstrated good internal consistency reliability (BDI-II = 0.91, PHQ-9 = 0.87); however, the PHQ-9 classifies more individuals as having "mild" depression symptoms relative to the BDI-II, which tends to suggest these individuals have no depression symptoms. Implications for assessing depression symptoms in individuals receiving substance abuse treatment are discussed.
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Affiliation(s)
- Kimberly A Hepner
- RAND Health Program, RAND Corporation, Santa Monica, CA 90407-2138, USA.
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VANHEULE STIJN, DESMET MATTIAS, MEGANCK REITSKE. WHAT THE HEART THINKS, THE TONGUE SPEAKS: A STUDY ON DEPRESSION AND LEXICAL CHOICE 1. Psychol Rep 2009. [DOI: 10.2466/pr0.104.2.472-481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Vanheule S, Desmet M, Meganck R. What the Heart Thinks, the Tongue Speaks: A Study on Depression and Lexical Choice. Psychol Rep 2009; 104:473-81. [DOI: 10.2466/pr0.104.2.473-481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study examined symptom-specificity in depression, testing the hypothesis that affective, cognitive, and somatic dimensions in depressive symptoms, as measured with the Beck Depression Inventory–II, cohere, respectively, with the use of affective-, cognitive-, and somatic-related words in natural language, as measured with the Linguistic Inquiry and Word Count. Based on questionnaire and interview data from 32 mental health outpatients, analyses indicate scores for affective depressive symptoms correlate significantly with affective word use, cognitive depressive symptoms are related to cognitively oriented word use combined with affective word use, and the presence of somatic depressive symptoms correlates significantly with words referring to physical states and functions. These results indicate that different facets of depression have specific correlates and that natural word use serves as a psychological marker. From a psychometric point of view, this study substantiates the concurrent validity of the Linguistic Inquiry and Word Count (LIWC2001) categories under study and the Beck Depression Inventory-II subscales for affective, cognitive, and somatic symptoms.
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Affiliation(s)
- Stijn Vanheule
- Department of Psychoanalysis and Clinical Consulting, Ghent University
| | - Mattias Desmet
- Department of Psychoanalysis and Clinical Consulting, Ghent University
| | - Reitske Meganck
- Department of Psychoanalysis and Clinical Consulting, Ghent University
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Liu ETH, Chen WL, Li YH, Wang CH, Mok TJ, Huang HS. Exploring the Efficacy of Cognitive Bibliotherapy and a Potential Mechanism of Change in the Treatment of Depressive Symptoms Among the Chinese: A Randomized Controlled Trial. COGNITIVE THERAPY AND RESEARCH 2008. [DOI: 10.1007/s10608-008-9228-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Keller F, Hautzinger M, Kühner C. Zur faktoriellen Struktur des deutschsprachigen BDI-II. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2008. [DOI: 10.1026/1616-3443.37.4.245] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das Beck-Depressionsinventar (BDI) wurde 1996 einer Revision (BDI-II) unterzogen und liegt seit 2006 auch in deutschsprachiger Version vor. Die faktorielle Struktur des Instruments wurde bereits in internationalen Studien untersucht mit dem Ergebnis, dass in psychiatrischen und gesunden nichtstudentischen Stichproben zwei hoch korrelierte Faktoren (kognitiv und somatisch-affektiv) angenommen werden können. Fragestellung: Im vorliegenden Beitrag soll die faktorielle Struktur des deutschsprachigen BDI-II untersucht werden. Methoden: An zwei Stichproben (266 Depressive und 582 Gesunde) wurde mit explorativen und konfirmatorischen Faktorenanalysen untersucht, welche faktorielle Struktur sich als am geeignetsten erweist. Ergebnisse: Eine Lösung mit zwei Faktoren erwies sich in beiden Stichproben nach Inspektion verschiedener statistischer Kriterien und inhaltlicher Überlegungen als am passendsten. Die Faktoren ließen sich inhaltlich als kognitiv und als somatisch-affektiv bezeichnen. Schlussfolgerungen: Für das deutsche BDI-II ergibt sich im Einklang mit internationalen Studien eine Aufsplittung in zwei hoch korrelierte Faktoren.
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Affiliation(s)
- Ferdinand Keller
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm
| | - Martin Hautzinger
- Abteilung Klinische und Physiologische Psychologie, Universität Tübingen
| | - Christine Kühner
- AG Verlaufs- und Interventionsforschung, Zentralinstitut für Seelische Gesundheit, Mannheim
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Osman A, Barrios FX, Gutierrez PM, Williams JE, Bailey J. Psychometric properties of the Beck Depression Inventory-II in nonclinical adolescent samples. J Clin Psychol 2008; 64:83-102. [PMID: 18161034 DOI: 10.1002/jclp.20433] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined the factor structure and psychometric properties of the Beck Depression Inventory-II (BDI-II; A. T. Beck, Steer, & Brown, 1996) in samples of high-school adolescents (N=414; 210 boys and 204 girls, ages 14-18 years). Confirmatory factor analyses provided satisfactory fit estimates for the two- and three-factor oblique solutions reported frequently in the extant literature. The solution to a general factor with domain-specific somatic and cognitive-affective factors was examined as an alternative model to previously established models for the current high-school sample data. Results provided stronger support for the general factor model. Estimates of internal consistency for scores on this instrument were high (coefficient alpha=.92, average interitem correlation=.35). The mean BDI-II total score for the nonclinical samples (M=12.50, SD=10.50) was compared with the mean scores reported for various adolescent normative samples in the extant literature. The BDI-II total score correlated moderately and significantly with scores on self-report measures of hopelessness (r=.63), anxiety (r=.53), and suicide-related behaviors (r=.57), providing support of adequate correlates for the BDI-II. Estimates of known-groups validity were evaluated using data from a small sample of 167 clinical adolescent inpatients. Specific study findings, limitations, and recommendations are discussed.
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Affiliation(s)
- Augustine Osman
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX 78249-0652, USA.
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Seignourel PJ, Green C, Schmitz JM. Factor structure and diagnostic efficiency of the BDI-II in treatment-seeking substance users. Drug Alcohol Depend 2008; 93:271-8. [PMID: 18093749 DOI: 10.1016/j.drugalcdep.2007.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 10/16/2007] [Accepted: 10/18/2007] [Indexed: 10/22/2022]
Abstract
Screening instruments are needed to rapidly and efficiently identify depression in drug and alcohol users. The Beck Depression Inventory-Second Edition (BDI-II) has excellent validity in psychiatric, normative and primary care samples, but its diagnostic efficiency has not been examined in substance users. Using a large sample of treatment-seeking substance users and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) to establish diagnosis, we examined the factor structure of the BDI-II and its ability to detect clinical depression, defined as the presence of a Major Depressive Disorder (MDD) or substance-induced depression. A three-factor structure provided the best fit, and the diagnostic efficiency of the BDI-II was moderate, and independent of gender and substance of abuse. Subscores had lower diagnostic efficiency than the BDI-II total score. A range of possible cutoff scores with corresponding sensitivity, specificity, positive predictive power and negative predictive power is provided to aid clinicians and researchers in choosing the optimal parameters for their screening needs.
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Affiliation(s)
- Paul J Seignourel
- Department of Psychiatry and Behavioral Sciences, University of Texas, 1300 Moursund Street, Houston, TX 77030, USA.
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Vanheule S, Desmet M, Groenvynck H, Rosseel Y, Fontaine J. The factor structure of the Beck Depression Inventory-II: an evaluation. Assessment 2008; 15:177-87. [PMID: 18182478 DOI: 10.1177/1073191107311261] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Beck Depression Inventory-II (BDI-II) is a frequently used scale for measuring depressive severity. BDI-II data (404 clinical; 695 nonclinical adults) were analyzed by means of confirmatory factor analysis to test whether the factor structure model with a somatic-affective and cognitive component of depression, formulated by Beck and colleagues, has a good fit. We also evaluated 10 alternative models. The fit of Beck's model was not good for all criteria. Three of the alternative models had a better fit in both samples, but none of these met all criteria for good fit. Of the alternatives with a better fit, we selected the only model with unidimensional subscales, which assesses a somatic, affective, and cognitive dimension. For this model, which we recommend, as well as for Beck' original model, a good fitting structure containing 15 and 16 items was developed with an item-deletion algorithm.
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Cha E, Erlen JA, Kim KH, Sereika SM, Caruthers D. Mediating roles of medication-taking self-efficacy and depressive symptoms on self-reported medication adherence in persons with HIV: a questionnaire survey. Int J Nurs Stud 2007; 45:1175-84. [PMID: 17949723 DOI: 10.1016/j.ijnurstu.2007.08.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2007] [Revised: 08/12/2007] [Accepted: 08/18/2007] [Indexed: 11/29/2022]
Abstract
BACKGROUND To date, only a few studies have examined the mediating role of self-efficacy on the relationship between depressive symptoms or perceived social support and medication adherence in persons with HIV. OBJECTIVES The purpose of this study was to examine the impact of perceived social support, depressive symptoms and medication-taking self-efficacy on self-reported medication adherence in persons with HIV. A proposed comprehensive model included three mediation hypotheses in order to examine the mediating roles of medication-taking self-efficacy and depressive symptoms. METHOD Baseline data from "Adherence to Protease Inhibitors" were used. The 215 persons with HIV aged 19-61 (mean=40.7, S.D.=7.58) were recruited from multiple sites in Pittsburgh, PA (USA) and through self-referral. The participants were assessed using the Beck Depression Inventory, Interpersonal Support Evaluation List, the Medication Taking Self-Efficacy Scale, and the modified Morisky Self-report Medication Taking Scale. Structural equation modeling (EQS version 6.1) was used. The Satorra-Bentler Scaled chi(2) test statistics (S-B chi(2)), Comparative Fit Index (CFI), and the Standardized Root Mean Squared Residual (SRMR) were used to assess the fit of a comprehensive model including three mediation hypotheses. RESULTS A comprehensive model with the three hypotheses showed a good model fit (S-B chi(2) (24, N=215)=69.06, p<.001; CFI=.95; SRMR=.057). Medication adherence self-efficacy fully mediated the prediction of self-reported medication adherence by perceived social support and depressive symptoms. Depressive symptoms partially mediated the prediction of medication-taking self-efficacy by perceived social support. CONCLUSIONS The findings of this study provide researchers with increased understanding of the mediating role of medication-taking self-efficacy beliefs between selected psychological variables and self-reported medication adherence in persons with HIV. Future studies need to test the moderating effect of gender, ethnicity and risk factors for HIV on this model and the intervention effect of self-efficacy beliefs using longitudinal data.
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Affiliation(s)
- Eunseok Cha
- Chung-Ang University, Department of Nursing School of Medicine, Seoul 156-756, South Korea.
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Johnson ME, Brems C, Mills ME, Fisher DG. Psychiatric symptomatology among individuals in alcohol detoxification treatment. Addict Behav 2007; 32:1745-52. [PMID: 17239548 PMCID: PMC2232900 DOI: 10.1016/j.addbeh.2006.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2006] [Revised: 11/14/2006] [Accepted: 12/08/2006] [Indexed: 11/30/2022]
Abstract
The coexistence of psychiatric symptomatology among individuals receiving longer-term treatment for alcohol use disorders has been well-established; however, less is known about comorbidity among individuals receiving alcohol detoxification. Using the Brief Symptom Inventory [BSI; Derogatis, L. R. (1992). BSI: Administration, scoring, and procedures manual--II. Towson, MD: Clinical Psychometric Research], we compared psychiatric symptomatology among 815 individuals receiving short-term detoxification services with normative data from non-patients, psychiatric patients, and out-of-treatment individuals using street drugs. Findings revealed that individuals in the current sample reported a wide range of psychiatric symptoms with over 80% meeting BSI criteria for diagnosable mental illness. These BSI scores were significantly more severe than those reported by out-of-treatment individuals using street drugs and most closely resembled BSI scores reported for adult psychiatric inpatients. Findings suggest that routine screening for severe mental health symptoms appears warranted in detoxification units. Such screening would greatly increase the chance that coexistence of substance use and other psychiatric disorders would be properly addressed in ongoing treatment.
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Affiliation(s)
- Mark E Johnson
- Behavioral Health Research and Services, University of Alaska Anchorage, United States.
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