Introduction: Patient-reported outcome measures (PROMs) are an important source of information that allow for a patient-centered assessment. Outcome measurement of substance use disorder (SUD) treatment traditionally focuses on drug use and deficits in functioning, overlooking other aspects of the personal and dynamic process of recovery. The substance use recovery evaluator (SURE) is a PROM developed with service user input to monitor the recovery journey and assess treatment outcomes in people with SUD.
View Article and Find Full Text PDFIntroduction: Patient-centred care has become increasingly important in health care. Patient-reported experience measures (PREM) are used to measure patient experiences in health care, but the availability of psychometrically validated PREMs is limited. The Patient Reported Experience Measure in Addiction Treatment (PREMAT) is a PREM developed with extensive service user input to assess the experiences of people in residential addiction treatment services.
View Article and Find Full Text PDFBackground: Substance use disorders (SUD) pose significant challenges for healthcare systems, and there is a need to monitor the provision of effective, individualized care to persons accessing treatment. Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) are increasingly used in healthcare services to measure treatment outcomes and quality of care as perceived by patients, and to guide service improvement.
Objectives: This review aims to identify and characterize international developments regarding the use and systematic implementation of PROMs and PREMs in SUD treatment services.
Baclofen may reduce the symptoms of alcohol withdrawal, as an alternative or as an adjuvant for benzodiazepines, but the available data are insufficient to support baclofen-assisted alcohol withdrawal. This study investigated the need for diazepam during acute alcohol withdrawal in patients receiving baclofen. In a single-blind, dose-dependent randomized controlled trial with three study arms, 63 patients with alcohol use disorder, starting in-patient benzodiazepine-assisted alcohol detoxification, were randomly assigned to receive placebo (n = 18), baclofen 30 mg/day (N = 20), or baclofen 60 mg/day (N = 25) for 7 days.
View Article and Find Full Text PDFBackground: Intimate and sexual feelings are common within psychotherapy, with negative outcomes when not managed adequately.
Aims: This study aims to investigate the understudied topic of these intimate and sexual feelings in basic education and psychotherapy training programs.
Method: In this convergent mixed method study, both a survey ( = 786) and 8 focus groups ( = 36) were conducted among psychotherapists in Flanders, Belgium (November 2016 - June 2018), using inferential and thematic analyses respectively.
Background: Belgium is one of the few countries worldwide where euthanasia on the grounds of unbearable suffering caused by a psychiatric disorder is legally possible. In April 2010 euthanasia was carried out on a 38-year-old Belgian woman with borderline personality disorder and/or autism. After a complaint by the family, three physicians were referred to the Court of Assizes on the charge of "murder by poisoning".
View Article and Find Full Text PDFObjective: An exponential implementation of remote mental health care has been observed, but little data is available on experiences and barriers of remote health from a patient's perspective. This study investigated experiences associated with several forms of remote consultations (both telephone and online video) for mental health care during the COVID-19 coronavirus pandemic with a particular focus on patients' experiences.
Methods: This study includes results of an online web-based survey filled in by 512 patients on the use and experiences of remote mental health consultations and circulating between March and October 2021.
Objective: Many therapists will one day be confronted with a patient who develops romantic or sexual feelings toward them. Studies on this topic often remain theoretical in nature and less often focus on how therapists manage such situations. Therefore, this study aimed to investigate how therapists experience this occurrence and manage their feelings.
View Article and Find Full Text PDFBackground: Substance use disorders (SUD) often co-occur with attention deficit hyperactivity disorder (ADHD). Although the short-term effects of some specific interventions have been investigated in randomized clinical trials, little is known about the long-term clinical course of treatment-seeking SUD patients with comorbid ADHD.
Aims: This paper presents the protocol and baseline clinical characteristics of the International Naturalistic Cohort Study of ADHD and SUD (INCAS) designed and conducted by the International Collaboration on ADHD and Substance Abuse (ICASA) foundation.
It is important that therapists manage adequately their romantic and sexual feelings toward clients as it can negatively affect the psychotherapeutic relationship and may even pose a risk of sexual abuse. This study explores how psychotherapists in Flanders (Belgium) manage such feelings, by conducting both a survey (using 105 of 786 respondents for analyses, as they reported romantic feelings) and focus groups (with a total of 36 participants). Results show that most therapists never consider starting a romantic relationship with a client.
View Article and Find Full Text PDFBackground: To prevent sexual boundary violations (SBV) in mental health care institutions overall governments require these institutions to report SBV incidents to a central registry and to develop institutional guidelines how to react. In Europe SBV policies are only recently developed or implemented, as is also the case in Flanders (Belgium). The implementation of a new institutional policy is always a challenge and can encounter resistance, especially when it concerns SBV, because they remain delicate and complex.
View Article and Find Full Text PDFA certain level of intimacy is necessary in psychotherapeutic relationships for them to be effective, but it can sometimes develop further into more intimate feelings and behaviors related to friendship and sexuality, into friendship, or even into sexual relationships. In this study, a self-administered questionnaire was sent to psychotherapists in Flanders (Belgium), asking about the occurrence of these situations. It provides an overview of these occurrences and comparative data to view for generational and cultural differences with previous studies.
View Article and Find Full Text PDFZ Kinder Jugendpsychiatr Psychother
January 2021
International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce.
View Article and Find Full Text PDFTalking about sexual feelings toward clients is still difficult for many mental health professionals. This is unfortunate, because exploring and talking about these feelings with peers (especially senior ones) or supervisors can help professionals to recognize, acknowledge, accept, and handle these feelings well. This focus group study explores the various factors that contribute to psychotherapists' hesitancy to talk about these feelings.
View Article and Find Full Text PDFAmong patients with substance use disorders (SUD), adult attention deficit hyperactivity disorder (ADHD) is one of the most frequently co-occuring disorder. Those SUD patients with comorbid ADHD show earlier onset of substance use, more severe SUD and poor treatment outcomes. Therefore, early recognition of ADHD is highly rele - vant within this patient population.
View Article and Find Full Text PDFBackground: The outbreak of coronavirus disease 19 (COVID-19) has led to measures of social distancing and quarantine worldwide. This stressful period may lead to psychological problems, including increases in substance use.
Objective: To investigate changes in alcohol, tobacco, and cannabis consumption before and during COVID-19 lockdown and motives for these changes in substance use.
Background: Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce.
View Article and Find Full Text PDFSpan J Psychiatry Ment Health
November 2023
Objective: This study aims to assess the validity of the ADHD module of the Mini-International Neuropsychiatric Interview (MINI-Plus) in patients with substance use disorders (SUD), using the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID) as the external criterion.
Method: A cross sectional international multi-center study in 10 countries was conducted in treatment seeking SUD patients. A sample of 1263 patients with both MINI-Plus and CAADID was analyzed to determine the psychometric properties of the MINI-Plus.
Background: To avoid harming or exploiting a client, sexual and non-sexual dual relationship is generally considered as unacceptable in the psychotherapeutic relationship. However, little is known about what therapists themselves constitute as (un)acceptable intimate and informal behaviour (IIB).
Methods: A survey among psychotherapists in Flanders (Belgium) was conducted.
This cross-sectional study aims to determine the prevalence of metabolic syndrome (MetS) in patients with severe mental illness (SMI) on a Caribbean island, Curaçao, using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Among 350 patients (240 men and 110 women) with a mean age of 51.9 years (S.
View Article and Find Full Text PDFPurpose Of Review: Attention-deficit and hyperactivity disorder (ADHD) often presents with comorbid substance use disorders (SUD). Due to similarities in key symptoms of both disorders and suboptimal efficacy of the available treatments, clinicians are faced with difficulties in the diagnosis and treatment of these patients with both disorders. This review addresses recent publications between 2017 and 2019 on the etiology, prevalence, diagnosis and treatment of co-occurring ADHD and SUD.
View Article and Find Full Text PDFAdult attention deficit/hyperactivity disorder (ADHD) often co-occurs with substance use disorders (SUD) and is associated with early onset and more severe development of SUD and with reduced treatment effectiveness. Screening tools allow for a good recognition of possible ADHD in adults with SUD and should be used routinely, followed by an ADHD diagnostic process initiated as soon as possible. Simultaneous and integrated treatment of ADHD and SUD, using a combination of pharmaco- and psychotherapy, is recommended.
View Article and Find Full Text PDFAim: Analysis of ethyl glucuronide (EtG) concentrations in hair is increasingly used to estimate the consumption of alcohol of the prior months. Linear correlations between the amount of alcohol consumed and the concentration of EtG in hair have been reported, and several variables that may influence this correlation have been investigated: e.g.
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