Acceptance and Commitment Therapy in the Treatment of Alcohol Use Disorder and Comorbid Affective Disorder: A Pilot Matched Control Trial.

This study examined whether acceptance and commitment therapy (ACT) enhances treatment as usual (TAU) in improving treatment outcomes in patients with alcohol use disorder (AUD) and comorbid affective disorder. Fifty-two participants were included in the study, of whom 26 were patients with AUD and either depression or bipolar disorder treated with ACT group therapy in parallel with TAU (inpatient integrated treatment) and 26 were matched controls who had received TAU alone. Drinking and craving outcomes were total alcohol abstinence, cumulative abstinence duration (CAD) and Obsessive Compulsive Drinking Scale (OCDS) scores at 3 and 6 months postintervention.

Task shifting--Ghana's community mental health workers' experiences and perceptions of their roles and scope of practice.

Background: Because of the absence of adequate numbers of psychiatrists, the bulk of mental health care at the community level in Ghana is provided by community mental health workers (CMHWs).

Objective: To examine the role and scope of practice of CMHWs in Ghana from their own perspectives and to make recommendations to improve the care they provide.

Design: We conducted a cross-sectional survey of 164 CMHWs from all the 10 administrative regions of Ghana, comprising 71 (43.

Task shifting of mental health care services in Ghana: ease of referral, perception and concerns of stakeholders about quality of care.

Objectives: To examine the perceptions of stakeholders about the ease of referral of patients from community mental health workers (CMHWs) to psychiatrists in Ghana and the level of stakeholder concerns about the quality of care provided to these community health cadres.

Design: A cross-sectional survey.

Participants: Eleven psychiatrists, 26 health policy directors and 164 community mental health workers, including 71 (43.

Factors influencing the career choice and retention of community mental health workers in Ghana.

Background: Whilst there have been several studies exploring retention in health workers, little is known about health workers engaged in the provision of mental health services and the factors that affect their recruitment and retention.

Aims: The objective of this research was to examine the views of stakeholders about the factors which influence career choices and retention of community mental health workers (CMHWs) in Ghana.

Methods: We administered three separate, self-administered, semi-structured questionnaires to 11 psychiatrists, 29 health policy directors and 164 CMHWs across Ghana, including 71 (43.

A 5-year follow-up of depressed and bipolar patients with alcohol use disorder in an Irish population.

Background: Alcohol use disorders (AUDs) and affective disorders commonly co-occur, and this co-occurrence is mutually detrimental. To date, few long-term outcome studies exist involving patients with these comorbid disorders. We wished to determine treatment outcomes 5 years after inpatient integrated treatment in patients with these co-occurring disorders, and identify prognostic factors associated with long-term outcome.

Six-months outcomes of a randomised trial of supportive text messaging for depression and comorbid alcohol use disorder.

Background And Objectives: We have previously reported that supportive text messages delivered twice daily for three months have the potential to provide personalised support for patients with depression and co-morbid Alcohol Use Disorder (AUD). In this study we report the six months outcomes.

Methods: Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive daily twice supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months.

Perception of patients with alcohol use disorder and comorbid depression about the usefulness of supportive text messages.

Background: Very little is known about the perception of patients with alcohol use disorder (AUD) and comorbid depression about the usefulness of supportive text messages.

Objective: To examine the perception of patients with AUD and comorbid depression about the usefulness of supportive text messages.

Methods: Participants (n=26) with a DSM IV diagnosis of AUD and depression and completing an in-patient dual diagnosis treatment programme had twice daily supportive text messages delivered to their mobile phones for three months as part of a randomised trial.

Prognostic factors of 2-year outcomes of patients with comorbid bipolar disorder or depression with alcohol dependence: importance of early abstinence.

Aims: To investigate the prognostic factors that determine 2-year outcomes in a group of alcohol-dependent patients with depression or bipolar disorder who were treated in an intensive 4-week inpatient programme.

Methods: This was a longitudinal study of an inpatient treatment cohort of dual affective disorder and alcohol-dependent patients, in Dublin, Ireland. Measurements included baseline demographics with follow-up measurements at discharge, 3 months, 6 months and 2 years after treatment, including alcohol consumption, depression, mania/elation, anxiety, craving, drug use and sample blood tests.

Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial.

Background: Mobile phone text message technology has the potential to improve outcomes for patients with depression and co-morbid Alcohol Use Disorder (AUD).

Aims: To perform a randomised rater-blinded trial to explore the effects of supportive text messages on mood and abstinence outcomes for patients with depression and co-morbid AUD.

Methods: Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive twice daily supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months.

Gender differences in outcome at 2-year follow-up of treated bipolar and depressed alcoholics.

Objective: Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.

Predictive factors for relapse after an integrated inpatient treatment programme for unipolar depressed and bipolar alcoholics.

Aim: The aim of this study was to examine prospectively examined predictors of relapse in alcohol dependence with comorbid affective disorder.

Methods: One hundred and eighty-three unipolar depressed or bipolar alcoholics who completed an integrated inpatient treatment programme for dual diagnosis were assessed at baseline, post-treatment discharge and at 3 and 6 months post treatment. Backwards stepwise likelihood ratio multiple logistic regression was used to investigate the impact of multiple covariates on relapse to alcohol in the 0-3- and 3-6-month period post discharge.

A double-blind, placebo-controlled study of sertraline with naltrexone for alcohol dependence.

Introduction: Significant preclinical evidence exists for a synergistic interaction between the opioid and the serotonin systems in determining alcohol consumption. Naltrexone, an opiate receptor antagonist, is approved for the treatment of alcohol dependence. This double-blind placebo-controlled study examined whether the efficacy of naltrexone would be augmented by concurrent treatment with sertraline, a selective serotonin receptor uptake inhibitor (SSRI).

Treatment response of bipolar and unipolar alcoholics to an inpatient dual diagnosis program.

Background: Depressed and bipolar alcoholics represent a significant affective subgroup that has a poorer prognosis than either diagnosis alone. To date few systematic treatment programs have been developed to treat dual diagnosis.

Methods: An inpatient treatment program was developed at St Patrick's Hospital Dublin to treat dual diagnosis clients with alcohol dependence and either unipolar or bipolar affective disorder.

Naltrexone and cognitive behavioral coping skills therapy for the treatment of alcohol drinking and eating disorder features in alcohol-dependent women: a randomized controlled trial.

Background: Despite important gender differences in drinking patterns, physiological effects of alcohol, and co-occurring psychiatric conditions, relatively little is known about the efficacy of naltrexone for the treatment of alcohol dependence in women. This study investigated the safety and efficacy of naltrexone in combination with Cognitive Behavioral Coping Skills Therapy (CBCST) in a sample of alcohol-dependent women, some with comorbid eating pathology.

Methods: One hundred three women meeting DSM-IV criteria for alcohol dependence (29 with comorbid eating disturbances) were randomized to receive either naltrexone 50 mg or placebo for 12 weeks in addition to weekly group CBCST.

A pilot double blind placebo controlled trial of sertraline with naltrexone in the treatment of opiate dependence.

Naltrexone has been used for thirty years as an aid to maintenance of opiate abstinence with limited success. One reason is that naltrexone does not appear to reduce craving in opiate addiction, unlike in alcoholism. The authors conducted this trial of naltrexone in combination with the SSRI sertraline to assess treatment retention with combination pharmacotherapy.