"It's a delicate balance": clinicians' experiences of providing heroin-assisted treatment.

Background: Little attention has been paid to the experiences of clinicians and health personnel who provide heroin-assisted treatment (HAT). This study provides the first empirical findings about the clinicians' experiences of providing HAT in the Norwegian context.

Methods: 23 qualitative interviews were conducted with 31 clinicians shortly after HAT clinics opened in Norway's two largest cities: Oslo and Bergen.

Evaluation of heroin-assisted treatment in Norway: protocol for a mixed methods study.

Background: Opioid agonist treatment (OAT) for patients with opioid use disorder (OUD) has a convincing evidence base, although variable retention rates suggest that it may not be beneficial for all. One of the options to include more patients is the introduction of heroin-assisted treatment (HAT), which involves the prescribing of pharmaceutical heroin in a clinical supervised setting. Clinical trials suggest that HAT positively affects illicit drug use, criminal behavior, quality of life, and health.

The role of contextual factors in avenues to recover from gambling disorder: a scoping review.

Introduction: Recovery from complex conditions such as gambling disorders (GD) often entail considerable change and require a range of adaptable interventions in the health care system. Outcomes from such avenues to change are influenced by multifarious contextual factors, which are less frequently considered in treatment outcome studies. Accordingly, this scoping review aims to map the level of evidence and explore how contextual factors influence the provision and outcomes of GD interventions.

Patients' satisfaction with heroin-assisted treatment: a qualitative study.

Background: Heroin-assisted treatment (HAT) involves supervised dispensing of medical heroin (diacetylmorphine) for people with opioid use disorder. Clinical evidence has demonstrated the effectiveness of HAT, but little is known about the self-reported satisfaction among the patients who receive this treatment. This study presents the first empirical findings about the patients' experiences of, and satisfaction with, HAT in the Norwegian context.

The effect of employment support integrated in substance use treatment: A health economic cost-effectiveness simulation of three different interventions.

Unemployment rates for individuals in treatment for substance use disorder (SUD) are high, with Norwegian estimates in the range of 81%-89%. Although Individual Placement and Support (IPS) represents a promising method to improved vocational outcome, cross-disciplinary investigations are needed to document implementation benefits and address reimbursements needs. The aim of this study was to model the potential socioeconomic value of employment support integrated in SUD treatment.

[Poor uptake of service provision at a drug-related emergency department – a qualitative study].

Background: The patient pathway for follow-up after a drug overdose, which is an important part of Norway's national overdose strategy, started up on 1 January 2022. Four years earlier, a collaboration was initiated between the ambulance service and the drug-related emergency department at Oslo University Hospital with the same aim as this patient pathway: to provide emergency follow-up in the specialist health service after a drug overdose. Uptake of the follow-up provision was minimal, and the purpose of this study was to investigate the reasons behind this.

Governing by commissioning services - Implementing alcohol screening and brief interventions in hospital settings in Norway.

Norwegian health services have undergone marked logistical changes in organization and funding over recent decades. One significant change was the new public management-inspired commissioner's document, first issued in 2013 by the Norwegian Ministry of Health and Care Services, to establish medical and surgical departments' identification of patients with underlying substance abuse problems (Ministry of Health and Care Services, 2013). Herein, we investigate how multiple stakeholders and actors, who bear responsibility in regional and local health trusts, have responded to the commissioned services to establish routines for identifying alcohol and substance abuse problems among patients admitted to medical and surgical wards.

Group treatment for complex dissociative disorders: a randomized clinical trial.

Background: Patients with complex dissociative disorders (CDD) report high levels of childhood- abuse experiences, clinical comorbidity, functional impairment, and treatment utilization. Although a few naturalistic studies indicate that these patients can benefit from psychotherapy, no randomized controlled trials have been reported with this patient-group. The current study evaluates a structured protocolled group treatment delivered in a naturalistic clinical setting to patients with CDD, as an add-on to individual treatment.

The effect evaluation of Individual Placement and Support (IPS) for patients with substance use disorders: study protocol for a randomized controlled trial of IPS versus enhanced self-help.

Background: Employment is associated with better outcomes of substance use treatment and protects against relapse after treatment completion. Unemployment rates are high for people with substance use disorders (SUD) who undergo treatment, with Norwegian estimates ranging from 81 to 91%. Evidence-based vocational models are lacking for patients in SUD treatment but exist for patients with psychosis in terms of Individual Placement and Support (IPS).

Vulnerability of personality disorder during the Covid-19 crises - a multicenter survey of treatment experiences among patients referred to treatment.

Background: The societal shutdown due to the Covid-19 pandemic involved mental health services for personality disorder (PD) and was introduced from 12 March 2020 in Norway. Rapid implementation of treatment modifications was required for patients typically characterized by insecure attachment and vulnerability to separation.

Aim: To investigate immediate reactions to the shutdown of services; alternative treatment received; and differences related to age in a clinical sample of patients with PD.

Stabilizing group treatment for childhood-abuse related PTSD: a randomized controlled trial.

: Patients with PTSD related to childhood-abuse often experience additional problems such as emotional dysregulation and interpersonal difficulties. Psychotherapy focused on stabilization of symptoms, emotion-regulation, and skills training has been suggested as a treatment for this patient population, either as preparation for further treatment or as a stand-alone intervention. : The present study tests the efficacy of treatment using a group-protocol for stabilizing treatment delivered adjunct with conventional individual therapy.

Quality of life among patients seeking treatment for substance use disorder, as measured with the EQ-5D-3L.

Purpose: There is a need to assess the quality of treatment for Substance Use Disorder (SUD), and document SUD patients' health-related quality of life (HRQoL). The study aims to describe Norwegian SUD patients' HRQoL as measured by EQ-5D, compared to a general population sample, and discuss the potential usefulness of the EQ-5D to monitor HRQoL for SUD patients.

Methods: One hundred seventy eight SUD patients (66.

A multi-center psychometric evaluation of the Severity Indices of Personality Problems 118 (SIPP-118): Do we really need all those facets?

Purpose: The Severity Indices of Personality Problems 118 (SIPP-118) is a self-report questionnaire that aims to measure core components of (mal)adaptive personality functioning that can change over time. In this study, we aimed to assess the facet strength of the 16 facets across three large clinical samples.

Methods: Data from Norwegian and Dutch psychiatric patients were analyzed in this international multi-center study (N = 2814, N = 4751, N = 2217).

Managing depressive symptoms in people with mild cognitive impairment and mild dementia with a multicomponent psychotherapy intervention: a randomized controlled trial.

Objective: To evaluate the feasibility and effectiveness of the CORDIAL program, a psychosocial intervention consisting of cognitive behavioral therapy (CBT), cognitive rehabilitation, and reminiscence to manage depressive symptoms for people with mild cognitive impairment (MCI) or dementia.

Design: We conducted a randomized controlled trial, based on a two-group (intervention and control), pre-/post-intervention design.

Setting: Participants were recruited from five different old age psychiatry and memory clinics at outpatients' hospitals.

Complementary horse-assisted therapy for substance use disorders: a randomized controlled trial.

Background: Treatment completion is the greatest challenge for the treatment of substance use disorders (SUDs). A previous investigation showed that complementary horse-assisted therapy (cHAT) was associated with higher retention in treatment and completion than standard treatment alone. This randomized controlled trial further explored the benefits of cHAT for patients with SUDs.

Effect of Self-Efficacy on Quality of Life in People With Mild Cognitive Impairment and Mild Dementia: The Mediating Roles of Depression and Anxiety.

Objectives: To examine the mediating effects of depression and anxiety in the relationship between self-efficacy and quality of life among people with mild cognitive impairment (MCI) or mild dementia.

Method: A total of 196 patients diagnosed with MCI or dementia due to Alzheimer disease completed structured measures of self-efficacy, quality of life, and depressive and anxiety symptoms. We examined direct and mediated effects by fitting structural equation models to data.

Measuring Personality Problems in Patients With Substance Use Disorders: A Cross-Sample Validation.

Co-occurrence of substance use disorder and personality disorder (PD) is associated with greater functional impairment and mutual deterioration of the prognosis. More information is needed about the extent of personality problems in substance use disorder patients and when these problems can be assessed in a reliable way. The aim of this study was to compare the levels and scale reliability of (mal)adaptive personality functioning in four different samples and to discuss the possible clinical implications.

Predicting Dropout from Inpatient Substance Use Disorder Treatment: A Prospective Validation Study of the OQ-Analyst.

Background And Aims: There is an urgent need for tools allowing therapists to identify patients at risk of dropout. The OQ-Analyst, an increasingly popular computer-based system, is used to track patient progress and predict dropout. However, we have been unable to find empirical documentation regarding the ability of OQ-Analyst to predict dropout.

The Montreal Cognitive Assessment as a predictor of dropout from residential substance use disorder treatment.

Background: Cognitive function is a challenge for many SUD patients, and residential SUD treatment is cognitively demanding. Treatment retention is a predictor for success in SUD treatment, and the literature links low cognitive function to increased dropout rates. In our study we investigate cognitive function and dropout in a residential SUD treatment setting, also accounting for psychological distress.

Treating Patients With Co-occurring Autism Spectrum Disorder and Substance Use Disorder: A Clinical Explorative Study.

Background: Substance use disorders (SUDs) have been assumed to be rare in individuals with autism spectrum disorder (ASD). Recent research suggests that the rates of SUD among individuals with ASD may be higher than assumed although reliable data on the prevalence of SUD in ASD are lacking. Typical interventions for SUD may be particularly unsuitable for people with ASD but research on intervention and therapy are limited.

Anabolic androgenic steroid dependence is associated with impaired emotion recognition.

Rationale: Illicit use of anabolic androgenic steroids (AAS) has grown into a serious public health concern throughout the Western World. AAS use is associated with adverse medical, psychological, and social consequences. Around 30% of AAS users develop a dependence syndrome with sustained use despite adverse side effects.

Measuring cognitive impairment in young adults with polysubstance use disorder with MoCA or BRIEF-A - The significance of psychiatric symptoms.

Introduction: Chronic polysubstance use disorder (PSUD) is associated with cognitive impairments. These impairments affect the quality of life, occupational functioning, and the ability to benefit from therapy. Psychological distress also affects neurocognitive status, and impaired neurocognition characterizes several psychiatric conditions.

Trauma-related altered states of consciousness in post-traumatic stress disorder patients with or without comorbid dissociative disorders.

: The four-dimensional ('4-D') model has been proposed as a theoretical framework to understand and delineate trauma-related dissociative experiences, categorizing symptoms into trauma-related altered states of consciousness (TRASC) and normal waking consciousness (NWC), which occur along four dimensions: time, thought, body and emotion. : The main aim of the present study was to evaluate the validity of this model in patients with post-traumatic stress disorder (PTSD), with and without comorbid dissociative disorders. : The predictions of the 4-D model were tested in 142 patients with PTSD, with ( = 46) and without ( = 96) comorbid dissociative disorders.

More Than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy.

Inclusion of horse-assisted therapy (HAT) in substance use disorder (SUD) treatment is rarely reported. Our previous studies show improved treatment retention and the importance of the patient-horse relationship. This qualitative study used thematic analysis, within a social constructionist framework, to explore how eight patients experienced contextual aspects of HAT's contribution to their SUD treatment.