The impact of mood symptomatology on pattern of substance use among homeless

Maremmani, Angelo Giovanni Icro; Bacciardi, Silvia; Gehring, Nicole D; Cambioli, Luca; Schütz, Christian; Akiskal, Hagop S.; Jang, Kerry L.; Krausz, Michael

doi:10.1016/j.jad.2015.01.059

Cited by 14 publications

(4 citation statements)

References 97 publications

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“…This risk is even higher in homeless women with BD (49.1% of alcohol dependence and 54.7% of substance dependence), confirming the findings reported in a recent study on patients with BD. 46 , 47 Therefore, public health services should pursue efforts for the prevention and care of addictive behavior in high need homeless people with SZ or BD, particularly in women with BD.…”

Section: Discussionmentioning

confidence: 99%

Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life

Tinland¹,

Boyer²,

Loubière³

et al. 2018

NDT

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ObjectiveThis study aimed to determine the following: 1) the proportion of women in the homeless population with schizophrenia (SZ) or bipolar disorder (BD), in addition to the trajectory of their homelessness (ie, homelessness history, number of nights spent without home during the 180 past nights) and the characteristics of their illnesses compared to men (ie, illness severity, suicide risk, physical health status, and quality of life [QoL]); 2) whether these women were victimized more frequently than similarly situated men; 3) the impact of victimization on these women in terms of illness severity, suicide risk, physical health status, and QoL; and lastly 4) the differences and overlap of homeless women with SZ and BD.MethodsThis study employed data at baseline from a multicenter randomized controlled trial conducted in the following four large French cities: Lille, Marseille, Paris, and Toulouse. Mobile mental health outreach teams recruited SZ/BD homeless patients in the street, emergency shelters, hospitals, and jails from August 2011 to April 2014. Evaluations were performed during face-to-face interviews by psychiatrists and research assistants in the offices of mobile mental health outreach teams that were located in the downtown area of each city. The quantitative data were analyzed using descriptive analyses, chi-square and Student’s t-tests, generalized estimating equation regression models, and path analysis.ResultsA total of 703 patients were included in this study. The proportion of women in the SZ/BD homeless population was 123/703 (17.5%). In this population, women were more likely than men to declare that they were subjected to physical or sexual assault during the past 6 months, that they had been diagnosed with posttraumatic stress disorder (PTSD), and that they had experienced more severe depressive symptoms. Moreover, these women presented a higher suicide risk, worse physical health status, and lower QoL than similarly situated men. Homeless women with BD were more vulnerable than women with SZ. A path analysis revealed that PTSD and violent victimization might explain the higher levels of depression and suicide risk and the lower levels of physical health status and QoL in homeless women.ConclusionSZ/BD homeless women experience more PTSD and victimization than men, which are both associated with poor clinical outcomes. These results confirm the vulnerability of homeless women in this high need population and should be considered by public health policy.

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Section: Discussionmentioning

confidence: 99%

Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life

Tinland¹,

Boyer²,

Loubière³

et al. 2018

NDT

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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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“…Nevertheless, those differences could be explained by certain correlates of BPD, by the presence of anxiety disorders and substance use disorders in particular. Indeed, the high prevalence of psychiatric comorbidities in bipolar subjects is well known (Asaad et al, 2014;Maremmani et al, 2015;Feingold et al, 2015;Gibbs et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Do bipolar subjects' responses to personality questionnaires lack reliability? Evidence from the PsyCoLaus study

Dupuis

Capel

Meier

et al. 2016

Psychiatry Research

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Differences in personality scores between subjects with and without mood disorders might result from response biases rather than specific personality traits per se. The aim of this study was to compare subjects with bipolar disorders (BPD) to non-bipolar subjects in terms of response quality to the NEO-FFI. Using data from the population-based cohort study PsyCoLaus, subjects were compared in terms of responses to the NEO-FFI, and indices of response quality were calculated. Hierarchical regression analyses were performed and controlled for sociodemographic factors, depressive episodes, dysthymia, anxiety disorders and substance use disorders. Consistent with the literature, subjects with BPD had higher scores in neuroticism and openness, and lower scores in conscientiousness. However, significant differences were measured for response reliability and validity. In particular, the indices of response quality including response reliability were lower in subjects with BPD suggesting that bipolar subjects might have more difficulty in providing consistent answers throughout questionnaires. However, regression models resulted in small associations between mania/hypomania and response quality, and showed that differences in response quality were mainly attributable to correlates of BPD instead of the presence of mania/hypomania itself. The current findings suggest that bipolar subjects' responses to questionnaires are biased, making them less reliable.

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The impact of mood symptomatology on pattern of substance use among homeless

Cited by 14 publications

References 97 publications

Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life

Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life

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

Do bipolar subjects' responses to personality questionnaires lack reliability? Evidence from the PsyCoLaus study

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