Psychopathology among Cocaine Abusers Entering Treatment

Kleinman, Paula H.; Miller, Amy; Millman, Robert B.; Woody, George; Todd, Thomas C.; Kemp, Jack; Lipton, Douglas S.

doi:10.1097/00005053-199007000-00005

Cited by 131 publications

(51 citation statements)

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“…There is a high prevalence of persons diagnosed with both a psychiatric disability and a chemical dependency in the United States, as evidenced by both epidemiological data and studies of treatment-seekers in substance abuse and mental health programs (Dixon, Haas, Weiden, Sweeney & Frances, 1991;Gawin & Kleber, 1985;Greenfield, Weiss & Tohen, 1995;Hesselbrock, Meyer & Keener, 1985;Kleinman, Miller & Millman, 1990;Marlowe et al, 1995;Mirin, Weiss & Michael, 1988;Rounseville, Anton & Carroll, 1991;Rounseville, Kosten, Weissman & Kleber, 1986;Rounseville, Weissman, Kleber & Wilber, 1982;Weiss et al, 1986). There is also evidence that those with lifetime comorbidity are more likely than those with a single disorder to experience major impairments in economic roles (e.g., unemployment, financial problems) and social roles (e.g., social isolation, interpersonal conflicts; see Kessler, 1995).…”

Section: Introductionmentioning

confidence: 99%

Double trouble in recovery: Self-help for people with dual diagnoses.

Vogel¹,

Knight²,

Laudet³

et al. 1998

Psychiatric Rehabilitation Journal

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Self-help is gaining increased acceptance among treatment professionals as the advent of managed care warrants the use of cost-effective modalities. Traditional "one disease-one recovery" self-help groups cannot serve adequately the needs of the dually diagnosed. This article discusses Double Trouble in Recovery (DTR), a 12-step self-help group designed to meet the special needs of those diagnosed with both a psychiatric disability and a chemical addiction, DTR differs from traditional self-help groups by offering people a safe forum to discuss their psychiatric disabilities, medication, and substance abuse. Preliminary data collected at four DTR sites in NYC indicate that DTR members have a long history of psychiatric disabilities and of substance abuse, and extensive experience with treatment programs in both areas. They are actively working on their recovery, as evidenced by their fairly intensive attendance at DTR. Recent substance use is limited, suggesting that participation in DTR (in conjunction with format treatment when needed) is having a positive effect. Most members require medication to control their psychiatric disabilities, and that alone may make attendance at "conventional" 12-step groups uncomfortable. Ratings of statements comparing DTR to other 12-step meetings suggest that DTR is a setting where members can feel comfortable and safe discussing their dual recovery needs.

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Section: Introductionmentioning

confidence: 99%

Double trouble in recovery: Self-help for people with dual diagnoses.

Vogel¹,

Knight²,

Laudet³

et al. 1998

Psychiatric Rehabilitation Journal

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show abstract

“…Poor motivation, personality disorders, and impaired social interactions of users, all of which may affect infant caregiving, have been reported (Griffin, Weiss, Mirin, & Lange, 1989;Kleinman et al, 1990;Newcomb, Bentler, & Fahy, 1987). Recent studies of poor, urban, cocaine using mothers postpartum found higher self-reports of psychological distress symptoms, especially interpersonal difficulties, paranoid ideation, and phobic anxiety, causing concerns that such symptoms may interfere with maternal provision of a responsive caregiving environment for her infant (Singer, Farkas, Arendt, Minnes, Yamashita, & Kliegman, 1995).…”

Section: Introductionmentioning

confidence: 99%

Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

et al. 1997

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Maternal cocaine use during pregnancy can affect the infant directly through toxic effects or indirectly through cocaine's influence on maternal psychological status. We followed 160 cocaine exposed and 56 nonexposed infants and their mothers identified at birth through interview and/or urine screen. Although cocaine exposure defined the groups, infant exposure to alcohol, marijuana, and tobacco was allowed to vary. Infants were 99% African American and poor. All mothers completed the Brief Symptom Inventory (BSI) and infants were given the Bayley Scales of Mental (MDI) and Motor (PDI) Development at a mean corrected age of 17 ± 8 months. Both MDIs (94 ± 17 vs. 103 ± 16) and PDIs (101 ± 16 vs. 108 ± 12) were lower for cocaine exposed infants. Psychological distress was greater in cocaine using mothers. Hierarchical multiple regression was used to assess the relative effects of gestational age, maternal psychological distress, and cocaine and polydrug exposure on infant outcomes. Both psychological distress and cocaine and alcohol exposure predicted lower MDIs after controlling for prematurity. Neither psychological distress nor alcohol exposure predicted motor outcome, while cocaine had a significant effect. Tobacco and marijuana exposure were unrelated to outcome. These findings provide further support for direct effects of cocaine and alcohol on infant development, as well as highlight the need for studies to document maternal psychological factors, which may increase child risk for poorer outcomes.

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“…Esse tipo de viés de seleção é causado por uma maior tendência de pessoas com múltiplos diagnósticos procurarem ou entrarem em tratamento, e então caírem em populações de estudo retiradas de fontes de tratamento (Berkson 5 , 1946). A prevalência de psicopatologia ao longo da vida, entre usuários de drogas que buscam tratamento, tem sido reportada como 20% mais alta do que a encontrada entre os usuários de drogas localizados na comunidade (Rounsaville et al 38 , 1991; Kleinman et al 22 , 1990; Regier et al 35 , 1990; Carrol e Rounsaville 11 , 1992).…”

Section: Resultsunclassified

“…Algumas pesquisas indicam que em uma certa proporção de usuários de cocaína, a depressão precede o abuso, sugerindo portanto que alguns indivíduos possam escolher a cocaína como uma tentativa de automedicar sintomas depressivos (Gawin e Kleber 16 , 1986; Weiss et al 39 , 1992; Kleinman et al 22 , 1990). Post et al 34 (1974), em um estudo no qual foi investigado o potencial antidepressivo da cocaína, encontraram que doses moderadas da droga elevavam o humor em pacientes deprimidos.…”

Section: Introductionunclassified

Transtornos mentais como fatores de risco para o desenvolvimento de abuso/dependência de cocaína: estudo caso-controle

Lopes

Coutinho

1999

Rev. Saúde Pública

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OBJETIVO: Avaliar o papel dos transtornos mentais e da dependência ao álcool como possíveis fatores de risco para o abuso/dependência de cocaína. MÉTODOS: Utilizou-se o desenho caso-controle e a técnica de bola-de-neve (snowball technique) para selecionar uma amostra de usuários de cocaína não tratados na comunidade (casos) e parear casos e controles por sexo, idade e amizade. A coleta de dados foi feita através da utilização do questionário CIDI (Composite International Diagnostic Interview) que gera diagnósticos de acordo com os critérios do Diagnostic and Statistical Manual of Mental Disorders-III-R. A análise dos dados foi feita através de regressão logística condicional. RESULTADOS: O estudo incluiu 208 indivíduos. Os principais resultados mostraram que história passada de dependência ao álcool era o principal fator associado a um aumento no risco de desenvolvimento de abuso de cocaína (OR=15,1; IC 95% 3,8-60,2); nenhum outro transtorno mental isolado manteve-se significativamente associado ao aumento deste risco após a análise multivariada. Aumento no risco de abuso de cocaína também foi encontrado entre os indivíduos que relataram pensamentos suicidas (OR=3,1; IC 95% 0,91-10,8), sugerindo associação entre quadros mais graves de depressão e abuso de cocaína. CONCLUSÕES: Esses achados sugerem que os programas voltados para a prevenção e tratamento do abuso de cocaína devem estar preparados para o manejo de questões relacionadas à co-morbidade do abuso de drogas com o álcool e outros distúrbios psiquiátricos.

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Psychopathology among Cocaine Abusers Entering Treatment

Cited by 131 publications

References 0 publications

Double trouble in recovery: Self-help for people with dual diagnoses.

Double trouble in recovery: Self-help for people with dual diagnoses.

Relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

Transtornos mentais como fatores de risco para o desenvolvimento de abuso/dependência de cocaína: estudo caso-controle

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