| 1. |
- Alm, Charlotta, et al.
(författare)
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Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6 : Analysis of three-year follow-up data and predictive validity
- 2014
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Ingår i: Mental Health and Substance Use. - Abingdon : Routledge. - 1752-3281 .- 1752-3273. ; 7:4, s. 431-445
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Tidskriftsartikel (refereegranskat)abstract
- Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.
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| 2. |
- Eriksson, Åsa, et al.
(författare)
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Offenders with mental health problems and substance misuse : cluster analysis based on the Addiction Severity Index version 6 (ASI-6)
- 2013
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Ingår i: Mental Health and Substance Use. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 6:1, s. 15-28
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Tidskriftsartikel (refereegranskat)abstract
- There is an urgent need to improve assessment and treatment among offenders with mental health problems and substance misuse (the “triply troubled”). An examination of the usefulness of the recently published Addiction Severity Index version 6 (ASI-6; Cacciola, J.S., Alterman, A.I., Habing, B., & McLellan, A.T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6). Addiction, 106, 1588–1602) in classifying offenders with mental health problems and substance misuse was undertaken. A total of 207 offenders with suspect mental disorder and substance misuse about to go through a forensic psychiatric evaluation in Sweden were interviewed with the ASI-6. Data were cluster analyzed. Four distinct clusters emerged: (1) “less troubled” (n=35), (2) “severely triply troubled” (nfl30), (3) “triply troubled with medical problems” (n=52) and (4) “working triply troubled” (n=87). The ASI-6 proved useful in the classification of offenders with mental health problems and substance misuse. The authors suggest that the ASI-6 be used in research on the classification of the triply troubled.
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| 3. |
- Nehlin Gordh, Christina, 1958-, et al.
(författare)
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Young female psychiatric patients' reasons for excessive alcohol use : a qualitative interview study
- 2013
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Ingår i: Mental Health and Substance Use. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 6:4, s. 315-324
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Tidskriftsartikel (refereegranskat)abstract
- There is a strong and multidirectional link between excessive alcohol use and psychiatric disorders. A large proportion (46.6%) of young female psychiatric outpatients report drinking above hazardous levels. This study explores high risk-drinking young female psychiatric patients' view of the role of alcohol in their lives. A further aim was to identify factors that may facilitate changes in drinking habits. Semi-structured interviews with open-ended questions were performed. The main areas of interest were: positive/negative aspects of alcohol use, risk situations for excessive drinking and factors facilitating change in drinking habits. Data were analysed using qualitative content analysis, a process that includes identifying, coding and categorizing components of the interviews. Nine female high risk-drinking psychiatric patients (mean age 22.2 ± 3.5 years) were interviewed. The reasons for excessive alcohol use were either external, in which case the young females wanted to live up to social expectations, or internal, in which case alcohol was used as an escape from negative feelings or for the purpose of self-harm. The participants requested help from psychiatric care-givers to focus on reasons for drinking and help with addressing underlying needs more functionally. To help avoid the development of complicated comorbidity, psychiatric providers must be aware of the role of alcohol in the patient's life. The categories identified in this study can be used by psychiatric health-care professionals in an interview scheme or checklist when meeting young female patients with excessive drinking.
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| 4. |
- Olsson, Tina M.
(författare)
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Productivity loss, victim costs and the intangible costs of crime : Followup to a longitudinal study of criminal justice system involvement and costs of women with co-occurring substance abuse and mental disorders in Sweden
- 2014
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Ingår i: Mental Health and Substance Use. - : Taylor & Francis. - 1752-3281 .- 1752-3273. ; 7:2, s. 102-109
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to estimate the cumulative productivity losses and victim costs incurred between 1975 and 2005 as a result of crimes committed by a cohort of women with a co-occurring substance abuse and mental disorder placed in a compulsory treatment facility for substance abuse between 1997 and 2000. As such, this adds to a prior study estimating the direct criminal justice system costs incurred for crimes committed by the same group during the same period. Official register data were obtained for the period 1975-2005 on a consecutive sample of 227 women. Total productivity losses due to homicide and incarceration as well as victim costs totaled approximately 250,000 Swedish crowns (2010 values, non-discounted) per person. Productivity losses and victim costs as estimated in this study accounted for roughly 19-25% of the societal costs of crimes committed by this group.
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| 5. |
- Olsson, Tina M., et al.
(författare)
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Women with co-occurring substance abuse and mental disorders in Sweden : a longitudinal study of criminal justice system involvement and costs
- 2013
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Ingår i: Mental Health and Substance Use. - London : Taylor & Francis. - 1752-3281 .- 1752-3273. ; 6:3, s. 219-236
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to estimate the cumulative direct criminal justice system costs incurred by age and offending year between 1975 and 2004 by a cohort of women with a co-occurring substance abuse and mental disorder (COD) placed in a compulsory treatment facility for substance abuse between 1997 and 2000. Official register data were obtained for the period 1975–2004 on criminal charges, prosecutions, judgments and sentences by a consecutive sample of 227 women. The 2010 unit price data were applied to resource use and total costs were calculated and reported by age and offending year. A total of 211 women (92.9%) were charged for at least one crime during the period under review. The mean length of criminal career was 8.58 years. Theft and narcotics offenses were the crime categories with the highest number of crimes committed and charges made. The total criminal justice system costs per person averaged 834,897 Swedish crowns (SEK, 2010) over the entire sample. This study provides cost data on the real criminal careers of women with COD which can be used to estimate the potential benefit of targeted interventions at various stages in an individual's criminal career. The results indicate that early, targeted, effective intervention can have substantial benefits.
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| 6. |
- Stålheim, Jonas, et al.
(författare)
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Mentalization and affect regulation reflected in interviews with men diagnosed with psychosis and substance abuse
- 2014
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Ingår i: Mental Health and Substance Use: Dual Diagnosis. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 7:4, s. 461-472
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Tidskriftsartikel (refereegranskat)abstract
- © 2014 Taylor & Francis. People with psychosis have a high prevalence of problematic substance use that is generally thought to complicate their treatment. One explanation of the co-occurrence of psychosis and substance-use disorders is that people with psychosis more often than others use substances to ameliorate distress by regulating their affect and self-experience. Affect regulation is related to mentalization, which can be problematic for many people with psychosis. The aim of this study was to investigate the relationship between substance use, mentalization, and affect regulation in psychosis from an experience-based perspective. We interviewed 12 men with diagnoses of psychosis and a concurrent substance-use disorder about their mental health problems, life history, relationships, and substance use. We analysed the semi-structured interviews thematically and deductively, and organized the data into two main themes, each containing related sub-themes. The first theme concerned general ways of handling distress, which we organized hierarchically according to the level of mentalization required. The other theme grouped together different regulating functions of substance use. We discuss, from a theoretical point of view, the systematic interactions among substance use, affect regulation, and mentalization indicated in the data and propose mentalization styles that may indicate especially high risk for substance abuse. These findings may have implications for theoretical understandings of how substance use and mental health problems interact and for verbal therapy for people with both psychosis and substance-use disorders.
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| 7. |
- Stålheim, Jonas, et al.
(författare)
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Substance use patterns in persons with psychosis
- 2013
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Ingår i: Mental Health and Substance Use. - 1752-3281 .- 1752-3273. ; 6:4, s. 351-361
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Tidskriftsartikel (refereegranskat)abstract
- Clinical experience suggests that people with psychosis generally show a diverging substance use pattern compared with other people with ‘dual disorders’. The aim of this study was to describe substance use patterns in individuals with psychosis and relate these to substance use patterns in persons with other kinds of psychiatric disorders in combination with substance abuse. A wider aim was to contribute to a deeper understanding of interactions between mental illness and substance use. Two groups were recruited, one with persons diagnosed with psychotic disorders and one with people with other (mainly anxiety- and affective-) disorders. All participants also had substance-related problems. The participants completed the questionnaires Alcohol Use Disorders Identification Test and Drug Use Disorders Identification Test, and information about socio-demographic and care-related characteristics was collected. Group differences were calculated. The participants with psychosis scored significantly lower on most questions concerning affective/cognitive aspects of drug use, such as longing, guilt and experience of failing in relation to alcohol and drugs. They also showed fewer indications of alcohol dependence. A possible interpretation is that the findings reflect group differences in mentalization and affect-regulation relevant to both substance use and psychiatric illness. This may have implications for theoretical understanding of dual disorders as well as for psychotherapeutic treatment.
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| 8. |
- Cruce, Gunilla, et al.
(författare)
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Experiences of alcohol and other drugs in individuals with severe mental illness and concomitant substance use disorders
- 2008
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Ingår i: Mental Health and Substance Use. - 1752-3281. ; 1:3, s. 228-241
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is well known that severe mental illness (SMI) with concurrent substance use disorders (SUD) commonly occurs. This comorbidity has distressing social, psychological, psychiatric and somatic consequences. Aim: To gain greater understanding of how individuals with SMI and SUD experience the roles of alcohol and other drugs for their health and in their life situation. Method: Eight individuals were interviewed on two occasions. The semi-structured interviews, which were based on an interview guide, were transcribed verbatim and analysed thematically. Results: Alcohol and drug use influenced the individuals’ own experiences of their health and life situation both in a positive and negative way. Substance use had meaning for their 1) experience of themselves – well-being and discomfort, energy and lack of energy, meaningfulness and disorientation, identity and personality change; 2) experiences of relationships – affiliation and alienation; 3) experiences of mental health – decreased and increased symptom levels. Conclusions: When providing treatment and support it seems important to be aware of a person’s own motives for using alcohol and drugs. From the individuals’ point of view their misuse appeared as a reasonable, but misguided effort to obtain control over his/her health and life situation.
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