[Risk of Hospitalization Among Patients With Co-Occurring Psychotic and Substance Use Disorders: A 12-Year Follow-Up].

[Risk of hospitalization among patients with co-occurring psychotic and substance use disorders: a 12-year follow-up].

Riv Psichiatr. 2013 Jan-Feb; 48(1): 51-9
Bartoli F, Scarone S, Clerici M

Aim. The study aims to analyze the impact of substance use disorders (SUD) on the risk of hospitalization among patients affected by psychotic disorders. Methods. During 1995, the patients consecutively admitted to psychiatric hospitalization or to an outpatient visit, were included in the study. Patients were interviewed by a questionnaire with specific reference to Addiction Severity Index (ASI), in order to assess the presence of SUD. During 2008, for each patient, the retrospective assessment of the days and the number of hospitalizations, due to psychiatric cause between 1996 and 2007, was performed. Results. During 1995, 102 patients were included in the study, 15 patients (14.7%) with a current SUD, 17 patients (16.7%) with a past SUD, and 70 patients (68.6% of the sample) without SUD. The follow-up analysis did not show any statistically significant difference among the three subgroups for what concerns the risk of receiving at least one hospitalization and the risk of involuntary treatment. By contrast, hospitalized patients with current SUD, if compared to hospitalized patients with past SUD or patients without SUD, appeared to have a significantly higher overall number of hospital admissions and days of hospitalization. Discussion. The current SUD group showed, in terms of hospitalizations, worse prognostic profiles than the group without SUD and the group with past SUD. The prominent role of a comprehensive assessment and a therapeutic strategy taking into account the potential negative effect of substance use on the stabilization of psychotic symptoms is therefore confirmed. HubMed – addiction

Alcohol Cues, Approach Bias, and Inhibitory Control: Applying a Dual Process Model of Addiction to Alcohol Sensitivity.

Psychol Addict Behav. 2013 Feb 25;
Fleming KA, Bartholow BD

Low sensitivity to the acute effects of alcohol is a risk factor for heavy drinking and related problems. However, little research has tested process explanations for such effects. The current study tested the hypothesis that low sensitivity is associated with automatic approach biases for alcohol cues, coupled with deficits inhibiting responses in the presence of such cues. Eighty-five participants varying in alcohol sensitivity completed an Alcohol-Approach Avoidance Task and a Cued Go/No-Go Task while event-related potentials were recorded. Low sensitivity (LS) individuals showed evidence of automatic approach tendencies toward alcohol cues in both tasks, and experienced deficits inhibiting prepotent responses cued by alcohol images. Additionally, the event-related potential data indicated that LS individuals experienced more conflict when attempting to inhibit alcohol-cued responses, but not nonalcohol-cued responses, compared with their high-sensitivity counterparts. Together, these data indicate that alcohol cues elicit an approach bias among LS individuals, translating into greater difficulty inhibiting behavioral responses in the presence of such cues, a pattern generally supportive of dual process models of substance use. (PsycINFO Database Record (c) 2013 APA, all rights reserved). HubMed – addiction

Sobering stories: Narratives of self-redemption predict behavioral change and improved health among recovering alcoholics.

J Pers Soc Psychol. 2013 Mar; 104(3): 576-90
Dunlop WL, Tracy JL

The present research examined whether the production of a narrative containing self-redemption (wherein the narrator describes a positive personality change following a negative experience) predicts positive behavioral change. In Study 1, we compared the narratives of alcoholics who had maintained their sobriety for over 4 years with those of alcoholics who had been sober 6 months or less. When describing their last drink, the former were significantly more likely to produce a narrative containing self-redemption than the latter. In Study 2, we examined the relation between the profession of self-redemption and behavioral change using a longitudinal design, by following the newly sober alcoholics from Study 1 over time. Although indistinguishable at initial assessment, newly sober alcoholics whose narratives included self-redemption were substantially more likely to maintain sobriety in the following months, compared to newly sober alcoholics who produced nonredemptive narratives; 83% of the redemptive group maintained sobriety between assessments, compared to 44% of nonredemptive participants. Redemptive participants in Study 2 also demonstrated improved health relative to the nonredemptive group. In both studies, the effects of self-redemption on sobriety and health held after controlling for relevant personality traits, alcohol dependence, recovery program involvement, initial physical and mental health, and additional narrative themes. Collectively, these results suggest that the production of a self-redemptive narrative may stimulate prolonged behavioral change and thus indicate a potentially modifiable psychological process that exhibits a major influence on recovery from addiction. (PsycINFO Database Record (c) 2013 APA, all rights reserved). HubMed – addiction

A survey of tobacco dependence treatment guidelines in 121 countries.

Addiction. 2013 Feb 26;
Piné-Abata H, McNeill A, Raw M, Bitton A, Rigotti N, Murray R

AIMS: To report progress among Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in developing national tobacco treatment guidelines in accordance with FCTC Article 14 guideline recommendations. DESIGN: Cross-sectional study SETTING: Electronic survey from December 2011 to August 2012; participants were asked to complete either an online or attached Word questionnaire. PARTICIPANTS: One hundred sixty-three of the 173 Parties to the FCTC at the time of our survey. MEASUREMENTS: The 51-item questionnaire contained 30 items specifically on guidelines. Questions covered the areas of guidelines writing process, content, key recommendations and other characteristics. FINDINGS: One hundred and twenty one countries (73%) responded. Fifty three countries (44%) had guidelines, ranging from 75% among high-income countries to 11% among low-income countries. Nearly all guidelines recommended brief advice (93%), intensive specialist support (96%), and medications (93%), while 66% recommended quitlines. Fifty seven percent had a dissemination strategy, 76% stated funding source and 68% had professional endorsement. CONCLUSION: Fewer than half of the Parties to the World Health Organization Framework Convention on Tobacco Control (FCTC) have developed national tobacco treatment guidelines, but where guidelines exist they broadly follow FCTC Article 14 guideline. HubMed – addiction

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