Substance Dependence Among Bipolar, Unipolar Depression and Psychotic Homeless: A Canadian National Study

Maremmani, Angelo Giovanni Icro; Bacciardi, Silvia; Somers, Julian M.; Nikoo, Mohammadali; Schütz, Christian; Jang, Kerry L.; Krausz, Michael

doi:10.3389/fpsyt.2018.00701

Cited by 9 publications

(7 citation statements)

References 68 publications

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“…(Habánik, 2018;Nishio et al, 2017). Among other factors, mental disorders play an important role, including psychotic disorders (Caton et al, 1994) and bipolar disorders (Maremmani et al, 2018). Fifty percent of HP have been considered to have some Kind of mental disorder (Scott, 1993).…”

Section: Introductionmentioning

confidence: 99%

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Martin

Andrés

Bullón

et al. 2020

Int J Soc Psychiatry

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Background: Homeless population has been severely affected by the COVID-19 pandemic. Their living conditions, comorbidity with different pathologies and a greater frequency of mental disorders, make this population vulnerable. Method: We implemented a program of serial visits in a hostel for confined homeless of the city council social services, for the monitoring and treatment of mental disorders and substance abuse problems. Accompanied by serial phone and email contacts. Results: A highly significant percentage (63%) had mental disorders or substance abuse, requiring pharmacological intervention, and 37% began follow-up in resources of the Mental Health and Addiction network of the Psychiatric Service at the end of the program. Hospital emergency service visits were drastically reduced. None of them were infected with COVID-19. An individualized Social plan was drawn up in order to reintegrate them with support in the community. Conclusions: The Results have been really positive, meeting all the objectives and opening up developing new programs in the future, in the pandemic outbreak and out of it.

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Section: Introductionmentioning

confidence: 99%

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Martin

Andrés

Bullón

et al. 2020

Int J Soc Psychiatry

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“…Extensive literature tells us about the prevalence rates of alcohol and/or drug use problems among these individuals [ 24 , 25 , 26 ], highlighting how these two disorders are highly debilitating and often comorbid conditions [ 27 , 28 , 29 , 30 ]. Epidemiological research suggests that rates of comorbid substance use disorders are higher in bipolar disorder than in any other psychiatric disorder [ 3 , 31 , 32 , 33 , 34 , 35 ]. The Epidemiologic Catchment Area study reported that over 60% of those with bipolar disorder had a comorbid substance use disorder, with 46% meeting criteria for alcohol use or dependence and 41% meeting criteria for drug use or dependence [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Substance Use/Dependence in Psychiatric Emergency Setting Leading to Hospitalization: Predictors of Continuity of Care

Maremmani

Aglietti²,

Intaschi³

et al. 2022

IJERPH

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Background: Poor adherence to treatment is a common clinical problem in individuals affected by mental illness and substance use/dependence. In Italy, mental care is organized in a psychiatric service and addiction unit (SERD), characterized by dual independent assets of treatment. This difference, in the Emergency Room setting, leads to a risk of discontinuity of treatment in case of hospitalization. In this study we clinically characterized individuals who decided to attend hospital post-discharge appointments at SERD, in accordance with medical advice. Methods: This is a retrospective study, based on two years of discharged records of patients entering “Versilia Hospital” (Viareggio, Italy) emergency room, with urinalyses testing positive for substance use, and hospitalization after psychiatric consultation. The sample was divided according to the presence or absence of SERD consultation after discharge. Results: In the 2-year period of the present study, 1005 individuals were hospitalized. Considering the inclusion criterion of the study, the sample consisted of 264 individuals. Of these, 128 patients attended post-discharge appointments at SERD showing urinalyses positive to cocaine, opiates, and poly use; they were more frequently diagnosed as personality disorder and less frequently as bipolar disorder. The prediction was higher for patients that had already been treated at SERD, for patients who received SERD consultation during hospitalization, and for patients with positive urinalyses to cocaine and opiates at treatment entry. Conversely, patients who did not attend SERD consultation after discharge were affected by bipolar disorders. Limitations: Small sample size. Demographical data are limited to gender and age due to paucity of data in hospital information systems. SERD is located far from the hospital and is open only on weekdays; thus, it cannot ensure a consultation with all inpatients. Conclusions: Mental illness diagnosis, the set of substance use positivity at hospitalization, and having received SERD consultation during hospitalization appeared to have a critical role in promoting continuity of care. Moreover, to reduce the gap between the need and the provision of the treatment, a more effective personalized individual program of care should be implemented.

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“…This study has limitations. The findings are based on a cross-sectional survey done in one city, and therefore, caution is needed when extrapolating these findings across different homeless populations or across different time points as they may not be generalizable [ 62 ]. Moreover, although several factors may have contributed to our results.…”

Section: Discussionmentioning

confidence: 99%

Non-beverage alcohol consumption among individuals experiencing chronic homelessness in Edmonton, Canada: a cross-sectional study

et al. 2021

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Background Among individuals experiencing homelessness, the prevalence of alcohol use disorder is extremely high. Alcohol-related harms are compounded by the use of non-beverage alcohol (NBA; e.g. rubbing alcohol, cooking wine). The dangers of NBA consumption pose significant risks to the individual and to others when consumed in large quantities and when mixed with other substances. The objectives of this paper are to describe the alcohol consumption patterns of individuals experiencing homelessness, identify substance use patterns, psychological stressors, and related harms associated with NBA consumption, and compare NBA consumers to non-NBA consumers in relation to their use of services and perceived barriers to care. Methods Using a cross-sectional survey, 150 individuals experiencing homelessness were recruited from Edmonton’s inner city and adjoining areas. Frequency, quantity, and volume of alcohol consumption were used to assess patterns of alcohol use in the last 6 months. Descriptive statistics and bivariate analyses were used to compare participants reporting NBA consumption and non-NBA consumption (p ≤ 0.05). Results The majority of participants were male (71.3%) and self-identified as Indigenous (74.0%). Overall, 24% (n = 36) reported NBA consumption within the last six months. NBA consumers were older than non-NBA consumers (p = 0.005), reported different perceived living stability (p = 0.022), and had higher psychological distress (p = 0.038). The majority of NBA consumers reported not receiving harm reduction services while also not needing such services (n = 18, 51.4%), which differed from non-NBA consumers (p = 0.003). Structural barriers (e.g. availability, location, cost) were most frequently reported as reasons for unmet harm reduction (60.9%) and hospital care (58.3%) needs, while barriers to skills training (58.5%) and counselling services (53.6%) were mostly motivational (e.g. personal beliefs). Conclusions Within such an already marginalized population experiencing homelessness, individuals who consume NBA represent a vulnerable subpopulation who require adapted and distinct health and social services to stabilize and recover. Current harm reduction services are not prepared to effectively assist this group of individuals, and specific treatment programs are rare. Managed alcohol programs are a feasible approach but must be tailored to the specific needs of those who consume NBA, which is especially important for Indigenous people. More comprehensive assessments of NBA consumption are needed for program development and policy recommendations.

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Substance Dependence Among Bipolar, Unipolar Depression and Psychotic Homeless: A Canadian National Study

Cited by 9 publications

References 68 publications

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Substance Use/Dependence in Psychiatric Emergency Setting Leading to Hospitalization: Predictors of Continuity of Care

Non-beverage alcohol consumption among individuals experiencing chronic homelessness in Edmonton, Canada: a cross-sectional study

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