| 1. |
- Hansson, Helena, et al.
(author)
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Intervention with feedback using Outcome Questionnaire 45 (OQ-45) in a Swedish psychiatric outpatient population. A randomized controlled trial.
- 2013
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 67:4, s. 274-281
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Journal article (peer-reviewed)abstract
- Aim: The objective of the study was to evaluate the efficacy of the Outcome Questionnaire 45 (OQ-45) with feedback in a Swedish psychiatric outpatient population using a randomized controlled design. Method: In all 1720 patients made at least one regular visit to the clinics in the period 12 February 2007 to 10 February 2008 and received information about the study. Of these, 374 patients (22%) agreed to participate. After written consent, 188 patients were randomized to the feedback group and 186 patients to the control group. Those constituted the intention-to-treat (ITT) group. Two hundred and sixty-two patients (70%) completed the OQ-45 questionnaire at least twice, and they were included in the per-protocol analysis. Those who improved less than expected and were at risk for treatment failure were called alerted patients. Results: There was a tendency that patients who received feedback improved more than the controls in OQ-45 total score. In the ITT analysis, the P-value was 0.061 and the effect size g = 0.21. In the per-protocol analysis the P-value was 0.076 and the effect size g = 0.24. In the intervention group, 27% of the patients were alerted because of risk of treatment failure vs. 28% in the control group (reaching level of alertness). The OQ-45 differences between the intervention and control groups did not significantly differ for patients who were alerted/reaching level of alertness and for non-alerted patients (g = 0.17 and g = 0.28, respectively). Conclusions: The feedback group had a tendency to improve more than the control group, possibly indicating that the method is effective, and the result (basically) supports previous findings.
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| 2. |
- Larsson Lindahl, Marianne, et al.
(author)
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Case management in aftercare of involuntarily committed patients with substance abuse. A randomized trial.
- 2013
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 67:3, s. 197-203
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Journal article (peer-reviewed)abstract
- Objective: Case management has since the 1970s been widely used to co-ordinate services for mental health patients. The methodology has expanded to support patients in many different types of conditions. This study is one of very few randomized trials on case management in a European setting. It examined the impact of case management on substance abuse and use of service after discharge from court-ordered institutional care. Methods: Court-ordered patients with substance abuse (n = 36) were randomly assigned to either strengths based case management or treatment-as-usual during 6 months in aftercare. Data was collected at intake, at conclusion of intervention and at 6 month's follow-up with a follow-up rate of 94%. Results: Case management interventions were well received by the patients with no drop-out during intervention. Patients with the support of a case manager seemed to sustain abstinence in a higher degree compared with treatment-as-usual but no differences were detected in regard to use of care. A subgroup analysis showed that patients with a continuous drug abuse did have access to care from both social welfare and hospital care systems. Conclusions: Case management may be useful in order to retain abstinence in aftercare following court-ordered treatment. The social welfare and hospital care systems seem to provide care irrespective of case manager intervention. The study design, interventions and assessments instruments were well received by patients but needs to be replicated with a larger population. Clinical implications: The 100% retention in the case management support group indicates that patients were satisfied with this type of intervention and the methodology seems to be useful in order to retain abstinence.
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| 3. |
- Larsson Lindahl, Marianne, et al.
(author)
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Commitment to coercive care in relation to substance abuse reports to the social services. A 2-year follow-up.
- 2010
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 64, s. 372-376
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Journal article (peer-reviewed)abstract
- Background: In Sweden, a person with substance abuse can be reported to the social services for an investigation about commitment to coercive care. After a change in legislation, municipalities varied greatly in the ratio of commitments/reports compared with the period before the legislation was amended. Aims: The primary aims of this study were first, to investigate whether subjects from municipalities with a high ratio of commitments/reports have a better outcome compared with subjects from municipalities with a low ratio and second, if a high ratio has an impact on mortality. Methods: The study involved two municipalities with high ratio of commitments/reports with 56 cases reported for substance abuse including 31 committed cases (55%). It also included two municipalities with a low ratio, 50 reported cases including six committed cases (12%). Two social service inspectors at the country administrative board assessed the cases in terms of severity of addiction according to legal criteria (kappa(s)=0.66), indicating good inter-rater agreement. A global index based on information about substance abuse, employment and housing was used as outcome measure at the 2-year follow-up. Results: Global outcome did not differ between cases from high- and low-ratio municipalities. Seven subjects had deceased because of causes related to substance abuse. None of the deceased had been committed to coercive care. Conclusions and clinical implications: In conclusion, the different ratios of commitments/reports did not influence global outcome. Commitment may reduce substance-related deaths.
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| 4. |
- Wennberg, Peter, et al.
(author)
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The AVI-R2 : an inventory for a differentiated diagnosis of alcohol problems
- 2014
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 68:4, s. 266-269
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Journal article (peer-reviewed)abstract
- Often in clinical practice, a diagnosis of alcohol dependence or abuse does not provide enough information to establish an adequate treatment plan. Hence, multidimensional instruments have been constructed better to describe the extent and character of a patient's alcohol problem. The purpose of the current article is to present the AVI-R2, a self-report test that provides a standardized and differentiated description of an ongoing drinking problem. The instrument includes 81 items categorized into 16 primary scales that were further summarized into four secondary scales: alcohol dependence, psychological benefits, relational complications and multiple dependence. The article provides reference values and psychometric properties of the Swedish version of the test. Data were based on 270 alcoholic patients recruited from the Centre for Dependency Disorders in Stockholm. Except for one primary scale (social complications due to drinking), the psychometric properties of the test were satisfactory. Recommendations on when and how the test can be used were also provided.
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