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Journal articles on the topic 'Dual diagnosis Patients Australia'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Eagle, Kerri, Trevor Ma, and Barbara Sinclair. "Integrated substance use rehabilitation in a secure forensic facility." Journal of Forensic Practice 21, no. 1 (January 31, 2019): 50–60. http://dx.doi.org/10.1108/jfp-09-2018-0037.

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Purpose The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems. Design/methodology/approach A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility. Findings The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme. Practical implications The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings. Originality/value Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.

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Vallesi, Shannen, Matthew Tuson, Andrew Davies, and Lisa Wood. "Multimorbidity among People Experiencing Homelessness—Insights from Primary Care Data." International Journal of Environmental Research and Public Health 18, no. 12 (June 16, 2021): 6498. http://dx.doi.org/10.3390/ijerph18126498.

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Background: Although the poor health of people experiencing homelessness is increasingly recognised in health discourse, there is a dearth of research that has quantified the nature and magnitude of chronic health issues and morbidity among people experiencing homelessness, particularly in the Australian context. Methods: Analysis of the medical records of 2068 “active” patients registered with a specialist homeless health service in Perth, Western Australia as of 31 December 2019. Results: Overall, 67.8% of patients had at least one chronic physical health condition, 67.5% had at least one mental health condition, and 61.6% had at least one alcohol or other drug (AOD) use disorder. Nearly half (47.8%) had a dual diagnosis of mental health and AOD use issues, and over a third (38.1%) were tri-morbid (mental health, AOD and physical health condition). Three-quarters (74.9%) were multimorbid or had at least two long-term conditions (LTCs), and on average, each patient had 3.3 LTCs. Conclusions: The study findings have substantial implications from both a health risk and healthcare treatment perspective for people experiencing homeless. The pervasiveness of preventable health conditions among people experiencing homelessness also highlights the imperative to improve the accessibility of public health programs and screening to reduce their morbidity and premature mortality.

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Zuo, Yeqin, Bernie Mullen, Rachel Hayhurst, Karen Kaye, Renee Granger, and Jonathan Dartnell. "OP08 Using Real World Data To Support National Postmarketing Surveillance." International Journal of Technology Assessment in Health Care 34, S1 (2018): 3. http://dx.doi.org/10.1017/s0266462318000739.

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Introduction:While medicines and medical tests are developed in a controlled clinical trial environment, postmarketing surveillance in the real world can be challenging. MedicineInsight—a database of longitudinal patient-level clinical information from primary care practices in Australia—is a novel program that collects primary care data to improve postmarketing surveillance at a national level.Methods:MedicineInsight collects de-identified clinical information from primary care practice information systems using data extraction tools. MedicineInsight currently includes 3.6 million regular patients of 3,300 family physicians (general practitioners) from 650 primary care practices across Australia. MedicineInsight data include longitudinal clinical information on diagnosis and medicines (dose, strength, route of administration, medication switches over time, adverse events, and allergies), and pathology testing data. A series of observational studies was developed for postmarketing surveillance of management of a range of health priorities including type 2 diabetes mellitus (T2DM), chronic obstructive pulmonary disease (COPD), depression, and antibiotics use.Results:Forty-four percent of patients with T2DM in the MedicineInsight database did not have a recorded hemoglobin A1c result and thirty-one percent did not have a recorded blood pressure reading in the previous 6 months. While guidelines recommend a stepwise approach to the initiation of COPD therapy, forty-nine percent of patients with COPD (with or without asthma) were prescribed dual therapy at initiation and a small number (4.5 percent) were prescribed triple therapy. Between 2011 and 2015, the annual rate of antidepressant prescribing per 1,000 family physician encounters increased by eight percent. High volumes of antibiotics were prescribed for respiratory tract infections in Australian primary care, notwithstanding guideline recommendations that antibiotics are not recommended in most cases.Conclusions:Large scale, real-world clinical data from primary care practices can play an important role in postmarketing surveillance at a national level.

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Mitchell, Paul, Devisri Dharmaraj, and Simon Knight. "Early-stage KRAS G12C-mutated non-small cell lung cancer (NSCLC) in Australia." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e21053-e21053. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e21053.

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e21053 Background: KRAS is frequently mutated in NSCLC, especially in Caucasian populations. Until recently there have not been effective targeted therapies against KRAS but the recent advent of active agents has thrown a spotlight on this disease. Methods: A database of NSCLC cases undergoing lobectomy or pneumonectomy with curative intent at Austin Health, Victoria, Australia was examined. Analysis for KRAS mutations was carried out using the LungCarta panel. Results: Four hundred and fifty nine cases underwent mutation analysis and 203/459 (44%) were wild type. KRAS mutations were identified in 100/459 cases (21.8%), including 3 cases where the specific mutation was not specified. KRAS G12C cases comprised 40/97 (8.5% of all cases, 41% of specified mutation KRAS cases) and other KRAS mutations comprised 57/97 (59%) - most commonly G12V (25 cases) and G12D (13 cases). Additional mutations were identified in 14/40 (36%) G12C mutation cases (10 dual and 4 triple – most commonly TP53 9, STK11 3 and PIC3CA 2). In non-G12C cases, multiple mutations were identified in 24% of cases. Considering the 40 G12C cases, histology was squamous cell in 21 cases, adenocarcinoma 13 and other 5. Males comprised 21/40 cases, median age at diagnosis was 61 year (range 34 – 78), with stage I 22 cases, stage II 12; stage IIIA 5 and one stage 4 (solitary brain metastasis). Thirty six patients (90%) had smoked tobacco with median exposure of 44 pack years (range 13-100) including 18 ex-smokers who had ceased a median 9 years (range 1 - 28) prior to the diagnosis of lung cancer. PD-L1 expression was analysed using the 28-8 antibody. For the 38 cases analysed, PD-L1 expression was ≥ 50% in 6 (16%), ≥ 5% in 12 (32%) and < 1% in 24 (63%). The estimated median overall survival was 4.9 years with 27% 10 year survival. Twenty three patients (58%) died from the index lung cancer, 8 (20%) remain alive and 9 (23%) died of other causes: 4 from a 2nd lung cancer, 4 from a non-lung cancer and one from liver failure. Data on sites of recurrence were available for 16 of the 23 cases who died from the index lung cancer, with initial recurrence sites being lung/local 7 patients, brain 6, bone 2, liver 1. A total of 9 patients (56%) developed brain metastases at some time. Conclusions: KRAS G12C is a common subgroup of NSCLC in the Australian population and almost all of cases were tobacco smokers. Additional mutations were identified in over a third of cases. Locally recurrent disease or brain metastases are the most frequent sites of relapse and over half of patients with recurrent disease develop brain metastases.

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Henry-Blake, C., K. Treadwell, S. Parmar, J. Higgs, M. Marshall, J. Edwards, and G. Peat. "POS1400 A SYSTEMATIC REVIEW OF INTERNATIONAL GUIDELINES REGARDING THE ROLE OF RADIOGRAPHY IN THE DIAGNOSIS OF OSTEOARTHRITIS." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 983.1–983. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3117.

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Background:A substantial proportion of primary care osteoarthritis (OA) consultations are associated with an X-ray request (1,2). Uncertainty exists regarding the ability of radiography to improve a clinical OA diagnosis, and the over-use of radiography may lead to inappropriate referrals due to severe radiographic features that do not correlate with patients’ symptoms. Additionally, there are cost implications of unnecessarily imaging such a prevalent disease. As evidence questions the utility of routine radiography in OA, the extent to which radiography is supported by international guidelines is unknown.Objectives:To undertake a systematic review and narrative synthesis of UK and international guideline recommendations on the role of radiography in the diagnosis of OA.Methods:A systematic search of eleven electronic databases (including EMBASE, MEDLINE CINAHL, Epistemonikos and Guideline Central) and the websites of nine professional organisations (including NICE, Royal College of Radiologists (RCR), EULAR, and the American College of Radiology (ACR)) identified the most recent evidence-based guidelines produced by professional organisations on the role of imaging in OA. Guidelines not addressing the role of radiography in the diagnosis of OA were excluded, as were non-English and spinal OA guidelines. Each title was screened by one reviewer whilst each abstract and full text underwent dual screening. A single reviewer, using a standard proforma, undertook data extraction. Each guideline was independently appraised by two reviewers using the AGREE II tool. A narrative synthesis of the nature and consistency of OA radiographic recommendations was performed.Results:18 evidence-based OA guidelines published between 1998-2019 were included. These guidelines considered OA at any joint (n=8), or at the knee (n=3), hip (n=2), hand (n=2), wrist (n=1), foot (n=1), and ankle (n=1). Seven guidelines were produced by European organisations; four guidelines were produced by EULAR. Guidelines were targeted at general practitioners (n=11), radiologists (n=7), rheumatologist (n=4) and orthopaedic surgeons (n=3). Using the AGREE II tool, the identified guidelines scored highly on rigour of development (mean score 69%) but poorly on applicability (32%). All 18 guidelines recommended X-rays as the first-line modality, where imaging was indicated. A clinical diagnosis of OA without radiographic confirmation was recommended by all eleven guidelines produced by organisations represented general practitioners, with seven guidelines justifying this due to a poor correlation between radiographic features and clinical symptoms. Only three guidelines explicitly discouraged the routine use of radiography for the diagnosis of OA and only two guidelines reassured practitioners of a low probability of missing serious pathology when not routinely requesting radiographs. Guidelines produced by organisations representing radiologists were more supportive of radiography. The ACR recommended radiographic confirmation in patients suspected to have OA at the hand, wrist, hip, knee, ankle, and foot. Conversely, the RCR recommended radiographic confirmation in patients suspected to have OA at the hand, feet, and hip, but not the knee.Conclusion:Differences in guideline recommendations on the utility of radiography in OA appear related to country/region, professional organisation, and joint. The use and utility of radiography in OA may need to be reviewed in light of a shift towards remote consultations, a change that has been accelerated by COVID-19 in many countries.References:[1]Yu D, Jordan K, Bedson J, Englund M, Blyth F, Turkiewicz A et al. Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992–2013. Rheumatology. 2017;56(11):1902-1917.[2]Brand C, Harrison C, Tropea J, Hinman R, Britt H, Bennell K. Management of Osteoarthritis in General Practice in Australia. Arthritis Care & Research. 2014;66(4):551-558Acknowledgements:JJE is funded by an Academic Clinical Lectureship from the National Institute for Health Research (NIHR) for this research project (CL-2016-10-003). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.Disclosure of Interests:None declared

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Lok, Sheau Wen, Richard De Boer, Sallt Baron-Hay, Peter Button, Bianca Devitt, Benjamin Forster, Peter Fox, et al. "Abstract P2-13-38: Pertuzumab study for HER2-positive non-metastatic breast cancer in the neoadjuvant setting in Australia." Cancer Research 82, no. 4_Supplement (February 15, 2022): P2–13–38—P2–13–38. http://dx.doi.org/10.1158/1538-7445.sabcs21-p2-13-38.

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Abstract BACKGROUND Adding pertuzumab to trastuzumab in patients (pts) with HER2+ breast cancer improves pathological complete response (pCR) rates. Pertuzumab + trastuzumab + chemotherapy is approved in Australia as neoadjuvant therapy in early stage (>2 cm or node positive), locally advanced and inflammatory HER2+ breast cancer. This study captured real-world data on the safety and effectiveness of pertuzumab in the neoadjuvant setting. METHODS PeRSIA (ML39622) is a secondary data use non-interventional study of pts initiating neoadjuvant pertuzumab treatment for non-metastatic HER2+ breast cancer. The primary objective is to assess the effectiveness and safety of neoadjuvant pertuzumab when added to trastuzumab in the real-world setting. Deidentified data obtained from the pts’ medical notes were captured using REDCaP, hosted at the Walter and Eliza Hall Institute of Medical Research. This analysis reports the co-primary endpoints of breast pCR (bpCR) with or without in situ disease (ypT0/is or ypT0), total pCR (tpCR) with or without in situ disease (ypT0/is ypN0 or ypT0 ypN0), and the incidence of adverse events (AEs) related to pertuzumab. Secondary objectives include describing rates of breast and nodal surgery, relapse free survival (RFS) and overall survival (OS). RESULTS Ninety five pts receiving neoadjuvant pertuzumab were enrolled between March 2018 and July 2019, with data available for all pts. HER2-targeted neoadjuvant treatment was completed in 91 pts (95.8%) with a median number of 4 cycles [range 1-6] of pertuzumab and 5 cycles [range 1-6] of trastuzumab. Four pts did not complete the planned neoadjuvant therapy due to early CR (n=1), and pertuzumab-related AEs (n=3). The most common neoadjuvant chemotherapy regimens were sequential anthracyclines + taxanes (n=59, 62.1%) and single agent taxane (n=29, 30.5%). Surgery was performed in 92 pts (96.8%). Three pts did not proceed to surgery due to patient decision (n=1), physician decision (n=1), and development of a new non-breast cancer which resulted in death (n=1). Of those pts that underwent surgery, 65/92 (70.7%) had a bpCR and 59/92 (64.1%) had a tpCR. All pts who did not achieve a pCR obtained a partial response (33/92, 35.9%). Total pCR was seen in 27/34 (79.4%) pts with hormone receptor-negative and 32/58 (55.2%) pts with hormone receptor-positive cancers. 27/95 (28.4%) pts experienced an AE related to pertuzumab; diarrhea (21.1%) and rash (4.2%) were the most common AEs. Three pts (3.2%) discontinued pertuzumab due to an AE: cardiac toxicity, diarrhea and rash (n=1), cardiac toxicity (n=1), and diarrhea and sepsis (n=1). Following surgery, 93/95 (97.9%) patients received adjuvant HER2-directed therapy, and 4/95 (4.2%) received adjuvant chemotherapy. After a median follow-up from diagnosis of 21.2 [14.0-83.9] months, the RFS and OS were 92.6% and 99.0% respectively. Disease recurrence occurred in 6 pts (distant n=4, contralateral n=2). CONCLUSIONS This is the first multicenter, observational study of neoadjuvant therapy based on dual blockade with pertuzumab and trastuzumab for HER2+ non-metastatic breast cancer in Australia. The pCR rates achieved were numerically higher than previously reported in clinical trials. There were no significant safety findings outside of the expected safety profile for pertuzumab. Acknowledgments: Study sponsored by Roche Products, Pty. Limited. Theresa Wade (WriteSource Medical) provided medical writing. Table: Baseline Characteristics (n=95)CharacteristicNumber (%)Age, median (range)50.3 (24.4 -82.1)Charlson Comorbidity Index- 077 (81.1)- 19 (9.5)- 2 +9 (9.5)Tumour Size12 (12.6)- T156 (59.0)- T225 (26.3)- T3- Unreported2 (2.1)Tumour Grade- 10 (0)- 231 (32.6)- 362 (65.3)- Unreported2 (2.1)Nodal status- Positive63 (66.3)- Negative32 (33.7)Hormone Receptor Status- HR+60 (63.2)- HR-35 (36.8)Median baseline left ventricular ejection fraction (range)65.0% (35-79)Cardiac risk factors- 053 (55.8)- 122 (23.2)- 2+20 (21.1) Citation Format: Sheau Wen Lok, Richard De Boer, Sallt Baron-Hay, Peter Button, Bianca Devitt, Benjamin Forster, Peter Fox, Michael Harold, Sahisha Ketheeswaran, Ganessan Kichenadasse, Belinda E Kiely, Gavin Marx, Louise Nott, Laura Pellegrini, Ali Tafreshi, Peter GIbbs. Pertuzumab study for HER2-positive non-metastatic breast cancer in the neoadjuvant setting in Australia [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-13-38.

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Stockfisch, Robert, Marc Galanter, and Harold Lifshutz. "Trends in Dual-Diagnosis Patients." American Journal on Addictions 4, no. 4 (October 1995): 356–57. http://dx.doi.org/10.1111/j.1521-0391.1995.tb00275.x.

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8

Gimelfarb, Y., Z. Natan, and Y. Baruch. "Suicide in dual diagnosis patients." European Psychiatry 22 (March 2007): S193—S194. http://dx.doi.org/10.1016/j.eurpsy.2007.01.640.

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Brunette, Mary F., and Douglas L. Noordsy. "ADHD in Dual Diagnosis Patients." Journal of Dual Diagnosis 6, no. 3-4 (December 30, 2010): 192–95. http://dx.doi.org/10.1080/15504263.2010.540773.

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Soyka, Michael. "Dual Diagnosis in Patients with Schizophrenia." CNS Drugs 5, no. 6 (June 1996): 414–25. http://dx.doi.org/10.2165/00023210-199605060-00002.

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Schneier, Max. "Better Treatment for Dual Diagnosis Patients." Psychiatric Services 51, no. 9 (September 2000): 1079. http://dx.doi.org/10.1176/appi.ps.51.9.1079.

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Donati, R., H. P. Hirsbrunner, J. Brodbeck, F. Moggi, and K. M. Bachmann. "Treatment Motivation among Dual Diagnosis Patients." European Psychiatry 12, S2 (1997): 200s. http://dx.doi.org/10.1016/s0924-9338(97)80611-6.

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Krysta, K., I. Krupka-Matuszczyk, A. Klasik, M. Matuszczyk, and M. Sygut. "Continuous attention in dual diagnosis patients." European Psychiatry 22 (March 2007): S119. http://dx.doi.org/10.1016/j.eurpsy.2007.01.381.

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Goldsmith, R. Jeffrey, and Vamsi Garlapati. "Behavioral interventions for dual-diagnosis patients." Psychiatric Clinics of North America 27, no. 4 (December 2004): 709–25. http://dx.doi.org/10.1016/j.psc.2004.07.002.

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Zimberg, Sheldon. "A Dual Diagnosis Typology to Improve Diagnosis and Treatment of Dual Disorder Patients." Journal of Psychoactive Drugs 31, no. 1 (January 1999): 47–51. http://dx.doi.org/10.1080/02791072.1999.10471725.

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Foster, Gavin. "“The dual diagnosis attitudes survey”: understanding the attitudinal impact of training across mental health and alcohol and drug service systems." Advances in Dual Diagnosis 13, no. 4 (October 30, 2020): 137–49. http://dx.doi.org/10.1108/add-05-2020-0004.

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Purpose Anecdotal feedback obtained from alcohol and drug and mental health staff across the eastern metropolitan region of Melbourne, Australia suggests that attitudes towards working with people experiencing a dual diagnosis are becoming more positive. The purpose of this paper is to understand if dual diagnosis-specific training delivered to staff within mental health and alcohol and other drug services was a factor positively influencing attitudes. Design/methodology/approach No formal evaluation assessing the impact of dual diagnosis-specific training on staff attitudes had previously occurred within this region of Australia. Access to staff on two occasions from three distinct sectors provided an opportunity to examine if and, to what degree, attitudes can be influenced by dual diagnosis-specific training. Using a co-designed attitudes survey, information was gathered from mental health and alcohol and drug staff on their attitudes to working with people with co-occurring mental health and substance use problems. Findings Two surveys were conducted involving 186 staff in 2012 and 110 staff in 2016. The dual diagnosis attitudes survey showed that positive attitudes to working with people experiencing a dual diagnosis were associated with recency of training. While attitudes may be improved by dual diagnosis training, these findings cannot exclude the impact of other dual diagnosis capacity building activities. Originality/value This study highlights the benefits of a regional partnership between mental health and alcohol and drug services and people with lived experience of dual diagnosis and the benefit of recent co-designed dual diagnosis training on longitudinally assessed worker attitudes.

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Price, Scott A., and Nancy C. Brahm. "Antipsychotic Treatment of Adolescent Dual Diagnosis Patients." Journal of Pediatric Pharmacology and Therapeutics 16, no. 4 (October 1, 2011): 226–36. http://dx.doi.org/10.5863/1551-6776-16.4.226.

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BACKGROUND A diagnosis of schizophrenia requires development of a pharmacotherapy regimen that balances many factors in the therapeutic decision-making process. Patient age and the presence or absence of comorbid chemical dependency represent two factors. Comorbid chemical dependency can have a profound impact on the successful treatment of schizophrenia, making patients with dual diagnoses of schizophrenia and chemical dependence a uniquely challenging population. There is little information regarding treatment of schizophrenia and chemical dependence in the pediatric population. Existing data from pediatric and adult populations may facilitate a well-guided and knowledgeable approach to treating pediatric dual diagnosis patients. METHODS A review of the literature for medication trials evaluating antipsychotic medication used to treat schizophrenia in childhood and adolescence as well as antipsychotic use in the treatment of the dual diagnoses of schizophrenia and chemical dependence was done. Databases for Ovid MEDLINE, PubMed, and PsycInfo were searched using the terms “addiction,” “adolescence,” “childhood,” “dual diagnosis,” “schizophrenia,” and “substance abuse.” Results were limited to English-language articles. RESULTS Seven articles were identified related to psychotic disorders and substance abuse in pediatric populations. Psychosis measurement instruments included the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale, and Clinical Global Impression. Mean improvements were insignificant in most cases. Medication trials included clozapine, olanzapine, risperidone, and molindone. Trial safety concerns included metabolic effects, increased prolactin levels, and akathisia. One study with random assignment to olanzapine was discontinued early because of substantial weight gain without evidence of superior efficacy. Clozapine treatment was associated with more adverse drug events. CONCLUSION There is a great need for more research and use of available data to develop safe and effective treatment guidelines for childhood and adolescent dual diagnosis patients. When appropriate decisions are made regarding treatment of patients with comorbid schizophrenia and chemical dependence, both conditions may benefit with increased remission.

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Subodh, BN, Nidhi Sharma, and Raghav Shah. "Psychosocial interventions in patients with dual diagnosis." Indian Journal of Psychiatry 60, no. 8 (2018): 494. http://dx.doi.org/10.4103/psychiatry.indianjpsychiatry_18_18.

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Renner, John A. "Training Psychiatrists to Treat Dual Diagnosis Patients." Journal of Dual Diagnosis 3, no. 2 (March 22, 2007): 125–36. http://dx.doi.org/10.1300/j374v03n02_14.

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Carey, Kate B., and Michael P. Carey. "Social problem-solving in dual diagnosis patients." Journal of Psychopathology and Behavioral Assessment 12, no. 3 (September 1990): 247–54. http://dx.doi.org/10.1007/bf00960621.

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Chiauzzi, Emil. "Brief inpatient treatment of dual diagnosis patients." New Directions for Mental Health Services 1994, no. 63 (1994): 47–57. http://dx.doi.org/10.1002/yd.23319946306.

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Barnes, Lynne, and Trudy Rudge. "Co-operation and co-morbidity: Managing dual diagnosis in rural South Australia." Collegian 10, no. 2 (January 2003): 25–28. http://dx.doi.org/10.1016/s1322-7696(08)60051-7.

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Roberts, Bridget M., and Darryl Maybery. "Dual Diagnosis Discourse in Victoria Australia: The Responsiveness of Mental Health Services." Journal of Dual Diagnosis 10, no. 3 (July 3, 2014): 139–44. http://dx.doi.org/10.1080/15504263.2014.929332.

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Pinderup, Pernille. "Challenges in working with patients with dual diagnosis." Advances in Dual Diagnosis 11, no. 2 (May 21, 2018): 60–75. http://dx.doi.org/10.1108/add-11-2017-0021.

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Purpose Studies have shown that mental health professionals find working with patients with dual diagnosis challenging, and the purpose of this paper is to examine some of these challenges. Design/methodology/approach In total, 85 mental health professionals from 8 different mental health centres in Denmark were interviewed. The data analysis was inspired by a grounded theory approach. Findings Different challenges in the dual diagnosis treatment were identified and they suggested that the focus of treatment was mainly on the mental illness rather than the substance use disorder. The single focus of the treatment made it challenging to treat patients with dual diagnosis sufficiently. While several studies explain the single focus by inadequate competencies among professionals, the present study suggests that the single focus is also explained by the way that the treatment is organised. For instance, standardized treatment packages and insufficient guidelines on substance abuse treatment make it challenging to treat patients with dual diagnosis. Originality/value This paper suggests that a more flexible, and a longer period of, treatment, together with more sufficient guidelines on dual diagnosis treatment and a more formalized collaboration with the substance abuse treatment centres, will make it a less challenging issue to treat patients with dual diagnosis.

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Lehman, Anthony F., C. Patrick Myers, Jeannette Johnson, and Lisa B. Dixon. "Service Needs and Utilization for Dual-Diagnosis Patients." American Journal on Addictions 4, no. 2 (February 18, 2010): 163–69. http://dx.doi.org/10.1111/j.1521-0391.1995.tb00448.x.

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Taylor, Stephen M., Marc Galanter, Helen Dermatis, Neal Spivack, and Susan Egelko. "Dual Diagnosis Patients in the Modified Therapeutic Community." Journal of Addictive Diseases 16, no. 3 (July 1997): 31–38. http://dx.doi.org/10.1300/j069v16n03_04.

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Adams, David H., Hong Liu-Seifert, and Bruce J. Kinon. "Dual Diagnosis Patients in Clinical Trials of Antipsychotics." Journal of Dual Diagnosis 3, no. 2 (March 22, 2007): 73–83. http://dx.doi.org/10.1300/j374v03n02_09.

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Baigent, Michael. "Managing patients with dual diagnosis in psychiatric practice." Current Opinion in Psychiatry 25, no. 3 (May 2012): 201–5. http://dx.doi.org/10.1097/yco.0b013e3283523d3d.

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de Waal, Marleen M., Carolien Christ, Jack J. M. Dekker, Martijn J. Kikkert, Nick M. Lommerse, Wim van den Brink, and Anna E. Goudriaan. "Factors associated with victimization in dual diagnosis patients." Journal of Substance Abuse Treatment 84 (January 2018): 68–77. http://dx.doi.org/10.1016/j.jsat.2017.11.001.

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Roncero, Carlos, Elena Ros-Cucurull, Lara Grau-López, Christian Fadeuilhe, and Miguel Casas. "Effectiveness of Inhaled Loxapine in Dual-Diagnosis Patients." Clinical Neuropharmacology 39, no. 4 (2016): 206–9. http://dx.doi.org/10.1097/wnf.0000000000000153.

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Bachmann, K. M., H. P. Hirsbrunner, F. Moggi, R. Donati, J. Brodbeck, C. Meier, and M. Schneider. "A New Diagnostic Instrument for Dual-Diagnosis Patients." European Psychiatry 12, S2 (1997): 220s. http://dx.doi.org/10.1016/s0924-9338(97)80692-x.

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Levy, Michael, Ruth Saemann, and Godehard Oepen. "Neurological Comorbidity in Treatment-Resistant Dual Diagnosis Patients." Journal of Psychoactive Drugs 28, no. 2 (April 1996): 103–10. http://dx.doi.org/10.1080/02791072.1996.10524383.

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Lehman, Anthony F., C. Patrick Myers, Jeannette Johnson, and Lisa B. Dixon. "Service Needs and Utilization for Dual-Diagnosis Patients." American Journal on Addictions 4, no. 2 (January 1995): 163–69. http://dx.doi.org/10.3109/10550499508997439.

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de Waal, Marleen Maria, Jacobus Johannes Maria Dekker, and Anna Emma Goudriaan. "Prevalence of Victimization in Patients With Dual Diagnosis." Journal of Dual Diagnosis 13, no. 2 (December 28, 2016): 119–23. http://dx.doi.org/10.1080/15504263.2016.1274067.

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Levy, Michael. "Psychotherapy with dual diagnosis patients: Working with denial." Journal of Substance Abuse Treatment 10, no. 6 (November 1993): 499–504. http://dx.doi.org/10.1016/0740-5472(93)90052-4.

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Edward, Karen-leigh, Rhonda Nelson Hearity, and Boyce Felstead. "Service integration for the dually diagnosed." Australian Journal of Primary Health 18, no. 1 (2012): 17. http://dx.doi.org/10.1071/py11031.

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The needs of dually diagnosed clients in mental health services have been and remain a focus for service development and improvement in Australia. The Council of Australian Governments committed to a five-year National Action Plan on Mental Health with a $1.8 billion injection into mental health services. In Australia there have been great advances in the service initiatives and service deliverables to those clients who experience a dual diagnosis. These advances include that dual diagnosis is systematically identified and responded to in a timely, evidence-based manner as a core business in mental health and alcohol and other drug services. These advances are brought to life by specialist mental health and alcohol and other drug services that establish effective partnerships and agreed mechanisms to support integrated care and collaborative practice. Here, four case studies are offered as a means of illustrating the ways in which projects undertaken in local community health services have approached dual diagnosis treatment for clients. These case studies reflect how cooperation and cross-referral between services, as well as effective management of dual diagnosis clients by suitably qualified staff can produce benefits to clients who use the service.

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Lopes, J., and R. Freitas. "Dual Diagnosis, Double Trouble." European Psychiatry 65, S1 (June 2022): S471. http://dx.doi.org/10.1192/j.eurpsy.2022.1197.

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Introduction Many individuals with severe mental illness (SMI) have substance use disorder comorbidity. Dual diagnosis makes the approach and management of these patients even more challenging since the lack of improvement in either pathologies can lead to a deterioration of both. Objectives To illustrate, through the presentation of two cases, the clinical challenges in managing a patient with dual diagnosis Methods Clinical case presentation through retrospective review of clinical notes and non-systematic literature review on this topic Results We present the clinical cases of two women diagnosed with Bipolar Disorder and (poly)Substance Use Disorder since adolescence, who have a history of multiple hospitalizations due to mostly maniform symptoms. The complexity of case management is evident, both at the pharmacological level and in psychosocial intervention. This is aggravated by the difficulty in maintaining adherence to the therapeutic project and frequent relapses. Conclusions Current evidence points to the beneficial effect of a combined pharmacological and psychosocial approach, which must be comprehensive, individualized and require differentiation at various levels that are difficult to achieve and make the treatment of these situations an even greater challenge. Using illustrative examples, this review draws attention to the practical difficulties in managing situations where substance use is associated with SMI. Disclosure No significant relationships.

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Álvarez, F. J., and J. C. Valderrama. "Tratamientos de los pacientes con patología dual Treatments of patients with dual diagnosis." Trastornos Adictivos 9, no. 2 (June 2007): 73–74. http://dx.doi.org/10.1016/s1575-0973(07)75633-7.

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Lehman, Anthony F., C. Patrick Myers, Lisa B. Dixon, and Jeannette L. Johnson. "Defining Subgroups of Dual Diagnosis Patients for Service Planning." Psychiatric Services 45, no. 6 (June 1994): 556–61. http://dx.doi.org/10.1176/ps.45.6.556.

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Modestin, Jiri, Christoph J. Studer Gladen, and Stephan Christen. "A Comparative Study on Schizophrenic Patients with Dual Diagnosis." Journal of Addictive Diseases 20, no. 4 (December 3, 2001): 45–55. http://dx.doi.org/10.1300/j069v20n04_05.

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Eggink, Esmé, Marleen M. de Waal, and Anna E. Goudriaan. "Criminal offending and associated factors in dual diagnosis patients." Psychiatry Research 273 (March 2019): 355–62. http://dx.doi.org/10.1016/j.psychres.2019.01.057.

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Wolfe, Harriet L., and James L. Sorensen. "Dual Diagnosis Patients in the Urban Psychiatric Emergency Room." Journal of Psychoactive Drugs 21, no. 2 (April 1989): 169–75. http://dx.doi.org/10.1080/02791072.1989.10472157.

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Osuji, I. Julian, Elizabeth Vera-Bolaños, Thomas J. Carmody, and E. Sherwood Brown. "Pregnenolone for cognition and mood in dual diagnosis patients." Psychiatry Research 178, no. 2 (July 2010): 309–12. http://dx.doi.org/10.1016/j.psychres.2009.09.006.

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Levy, Michael S. "Engaging Dual Diagnosis Patients into Treatment: The T.E.E.A.C.H. Program." Journal of Psychoactive Drugs 34, no. 4 (December 1, 2002): 409–13. http://dx.doi.org/10.1080/02791072.2002.10399982.

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Roberts, Bridget, and Rebecca Jones. "Dual Diagnosis Narratives and Their Implications for the Alcohol and other Drug Sector in Australia." Contemporary Drug Problems 39, no. 4 (December 2012): 663–85. http://dx.doi.org/10.1177/009145091203900404.

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Dual diagnosis discourse, concerning people who are diagnosed with both mental health and substance use problems, has attracted little critical analysis. This article aids reflection on its implications for alcohol and other drug (AOD) treatment services. Qualitative analysis of 19 interviews with a purposive sample of service providers and public servants was validated with informants. Three contrasting narratives emerged—progressive (dual diagnosis discourse has lifted the sector to a level where services can better respond to complex needs in general); remedial (it has simply helped to improve the workforce's expertise in AOD treatment and “catch up”with mental health services); and radical (by patching a fragmented system it has dampened demands for major system reform). The diversity of views supports an argument for a metanarrative which, combining the strengths of the three narratives, continues to pioneer, to educate and, crucially, is explicitly conceptualized as part of a broader picture of well-resourced structural reform.

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Delicato, C., E. Gattoni, S. Di Marco, C. Vecchi, A. Venesia, P. Zeppegno, and C. Gramaglia. "Resilience and Psychological Correlates in a Group of Patients Affected by Dual Diagnosis." European Psychiatry 41, S1 (April 2017): S202. http://dx.doi.org/10.1016/j.eurpsy.2017.01.2153.

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IntroductionAlthough several authors found a strong association between childhood trauma and substance abuse disorder, many other suggest that specific personological aspects and resilience may contribute to the development of this disease.ObjectivesTo compare the characteristics of psychiatric patients with and without dual diagnosis assessing differences in psychological correlates, such as resilience, coping strategies, self-esteem, temperament, character traits and childhood trauma.MethodsFrom November 2015 to May 2016, we recruited all patients aged between 18 to 65 years referred to the Psychiatry Ward of “Maggiore della Carità” Hospital in Novara, Italy. Diagnosis of psychiatric disorder was made according to DSM-5 diagnostic criteria. Exclusion criteria were: inability to express a valid inform consent, a personality disorder or mental retardation diagnosis. We administered to each patient: Resilience Scale for Adult (RSA), Brief Cope, Rosenberg Self-esteem Scale (RSES), Childhood Trauma Questionnaire (CTQ), Temperament and Character Inventory (TCI). Patients were subdivided for the analysis into two groups: dual diagnosis and no dual diagnosis (or single diagnosis) group.ResultsData show that dual-diagnosis patients (n = 40) had lower global levels of resilience (RSA) and cooperativeness (TCI). Higher novelty seeking and reward dependence traits (TCI) were found as well. Moreover, the lower Cope-Avoidance (Brief Cope) was statistically different among patients with dual diagnosis compared to single diagnosis ones.ConclusionsIdentified differences between these two groups could suggest targets to manage during the treatments in order to optimise dual diagnosis patients’ outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Leon, Scott C., John S. Lyons, Nina J. Christopher, and Sheldon I. Miller. "Psychiatric Hospital Outcomes of Dual Diagnosis Patients Under Managed Care." American Journal on Addictions 7, no. 1 (January 1998): 81–86. http://dx.doi.org/10.3109/10550499809034715.

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Luoto, Kaisa E., Antti Koivukangas, Antero Lassila, and Olli Kampman. "Outcome of patients with dual diagnosis in secondary psychiatric care." Nordic Journal of Psychiatry 70, no. 6 (April 6, 2016): 470–76. http://dx.doi.org/10.3109/08039488.2016.1160149.

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Alger, Ian. "Rehabilitating Dual Diagnosis Patients in the Community; Understanding Group Therapy." Psychiatric Services 44, no. 4 (April 1993): 332–36. http://dx.doi.org/10.1176/ps.44.4.332.

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Alger, Ian. "Rehabilitating Dual Diagnosis Patients in the Community; Understanding Group Therapy." Psychiatric Services 44, no. 6 (June 1993): 597—a—597. http://dx.doi.org/10.1176/ps.44.6.597-a.

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