Technology Use and Interest in Computerized Psychotherapy: A Survey of Veterans in Treatment for Substance Use Disorders.

Introduction: This study examined interest in computerized psychotherapies (CPTs) and its relation to use of information technology among individuals receiving Veterans Health Administration (VHA) outpatient treatment.

Materials And Methods: Veterans receiving treatment in a VHA substance use disorder outpatient clinic completed a self-report questionnaire. The survey addressed recent experience using information technology and potential interest in using CPTs for symptoms/functional problems associated with substance use and mental health disorders.

Prevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration.

We used national data for fiscal year 2012 to examine demographic, psychiatric and medical diagnoses, indications for psychotropics, and service use correlates of psychotropic medication fills in Veterans with at least 10 opioid prescriptions during the year (the highest 29% of opioid users); and whether the Veteran was treated in a specialty mental health clinic. Of the 328,398 Veterans who filled at least 10 opioid prescriptions, 77% also received psychotropics, of whom: 74% received antidepressants, 55% anxiolytics/sedatives/hypnotics, and 26% three or more classes of psychotropic medications. Altogether, 87% had a psychiatric or medical indication; and 54% received mental health treatment.

Brief Chinese version of the Family Experience Interview Schedule to assess caregiver burden of family members of individuals with mental disorders.

Background: Caregiver burden is an important issue that needs to be addressed when developing management programs for persons with chronic mental illnesses, but there is, as yet, no reliable way for assessing this in China.

Aim: Assess the validity and reliability of a brief adapted Chinese version of the Family Experience Interview Schedule (FEIS) among caregivers of inpatients with mental disorders in China.

Methods: We first translated and back-translated the original 114-item FEIS and administered it to 606 primary caregivers of psychiatric inpatients.

The RAISE early treatment program for first-episode psychosis: background, rationale, and study design.

Objective: The premise of the National Institute of Mental Health Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) is to combine state-of-the-art pharmacologic and psychosocial treatments delivered by a well-trained, multidisciplinary team in order to significantly improve the functional outcome and quality of life for first-episode psychosis patients. The study is being conducted in non-academic (ie, real-world) treatment settings, using primarily extant reimbursement mechanisms.

Method: We developed a treatment model and training program based on extensive literature review and expert consultation.

Psychiatric services and prescription fills among veterans with serious mental illness in methadone maintenance treatment.

Objective: Comorbidity and co-prescription patterns of people with serious mental illness in methadone maintenance may complicate their treatment and have not been studied. The goal of this study was to examine the care and characteristics of people with serious mental illness in methadone maintenance treatment nationally in the Veterans Health Administration (VHA).

Methods: Using national VHA data from FY2012, bivariate and multiple logistic regression analyses were used to compare veterans in methadone maintenance treatment wo had a serious mental illness (schizophrenia, bipolar disorder, or major affective disorder) to patients in methadone maintenance treatment without serious mental illness and patients with serious mental illness who were not in methadone maintenance treatment.

The NAVIGATE Program for First-Episode Psychosis: Rationale, Overview, and Description of Psychosocial Components.

Comprehensive coordinated specialty care programs for first-episode psychosis have been widely implemented in other countries but not in the United States. The National Institute of Mental Health's Recovery After an Initial Schizophrenia Episode (RAISE) initiative focused on the development and evaluation of first-episode treatment programs designed for the U.S.

Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study.

Objective: Treatment guidelines suggest distinctive medication strategies for first-episode and multiepisode patients with schizophrenia. To assess the extent to which community clinicians adjust their usual treatment regimens for first-episode patients, the authors examined prescription patterns and factors associated with prescription choice in a national cohort of early-phase patients.

Method: Prescription data at study entry were obtained from 404 participants in the Recovery After an Initial Schizophrenia Episode Project's Early Treatment Program (RAISE-ETP), a nationwide multisite effectiveness study for patients with first-episode schizophrenia spectrum disorders.

VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association.

Objective: There has long been concern that public support payments are used to support addictive behaviors. This study examined the amount of money homeless veterans spend on alcohol and drugs and the association between public support income, including VA disability compensation, and expenditures on alcohol and drugs.

Methods: Data were from 1,160 veterans from 19 sites on entry into the Housing and Urban Development-Veterans Affairs Supportive Housing program.

Risk factors for homelessness among US veterans.

Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans.

Duration of Untreated Psychosis in Community Treatment Settings in the United States.

Objective: This study is the first to examine duration of untreated psychosis (DUP) among persons receiving care in community mental health centers in the United States.

Methods: Participants were 404 individuals (ages 15-40) who presented for treatment for first-episode psychosis at 34 nonacademic clinics in 21 states. DUP and individual- and site-level variables were measured.

Insight in inpatients with schizophrenia: relationship to symptoms and neuropsychological functioning.

Objective: Lack of insight into illness has long been recognized as a central characteristic of schizophrenia. Although recent theories have emphasized neurocognitive dysfunction as a central impairment in schizophrenia it remains unclear whether the lack of insight in schizophrenia is more strongly associated with measures of symptom severity or neuropsychological dysfunction.

Methods: Seventy-four consecutive inpatients with chronic schizophrenia were enrolled in a cross-sectional study.

PTSD and substance use disorder among veterans: characteristics, service utilization and pharmacotherapy.

Objective: While there has been considerable concern about veterans with dually diagnosed posttraumatic stress disorder (PTSD) and comorbid substance use disorders, a national study of clinical characteristics, service utilization, and psychotropic medication use of such veterans in Veterans Affairs (VA) has yet to be conducted. We hypothesized that veterans having both PTSD and substance use disorder would have lower socioeconomic status, greater medical and psychiatric comorbidity, higher medical service utilization, and more psychotropic pharmacotherapy fills.

Methods: National VA data from fiscal year 2012 were used to compare veterans with dually diagnosed PTSD and substance use disorder to veterans with PTSD without substance use disorder on sociodemographic characteristics, psychiatric and medical comorbidities, mental health and medical service utilization, and psychotropic pharmacotherapy.

Elucidating the transdiagnostic dimensional structure of trauma-related psychopathology: Findings from VA cooperative study 504 - risperidone treatment for military service related chronic post traumatic stress disorder.

Background: Three of the most common trauma-related mental disorders-posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD)-are highly comorbid and share common transdiagnostic symptom dimensions of threat (i.e., fear) and loss (i.

Residential Treatment for Posttraumatic Stress Disorder in the Department of Veterans Affairs: A National Perspective on.

Thirty-eight U.S. Department of Veterans Affairs's (VA) residential treatment programs for posttraumatic stress disorder took part in a formative evaluation of their programmatic services, including perceptions of effective treatment.

Homeless and nonhomeless VA service users likely eligible for Medicaid expansion.

Administrative data on the population of Department of Veterans Affairs (VA) service users in 2010 under the age of 65 (n = 3,841,225) were analyzed to identify the number and characteristics of homeless and nonhomeless VA service users who are likely to be eligible for the Medicaid expansion (LEME) option under the Affordable Care Act. Results showed that, estimating conservatively, about 1.2 million (21%) current VA users are LEME if all states implement the expansion.

The impact of missing data on the results of a schizophrenia study.

Missing data pose a serious challenge to the integrity of randomized clinical trials, especially of treatments for prolonged illnesses such as schizophrenia, in which long-term impact assessment is of great importance, but the follow-up rates are often no more than 50%. Sensitivity analysis using Bayesian modeling for missing data offers a systematic approach to assessing the sensitivity of the inferences made on the basis of observed data. This paper uses data from an 18-month study of veterans with schizophrenia to demonstrate this approach.

Cardiometabolic risk in patients with first-episode schizophrenia spectrum disorders: baseline results from the RAISE-ETP study.

Importance: The fact that individuals with schizophrenia have high cardiovascular morbidity and mortality is well established. However, risk status and moderators or mediators in the earliest stages of illness are less clear.

Objective: To assess cardiometabolic risk in first-episode schizophrenia spectrum disorders (FES) and its relationship to illness duration, antipsychotic treatment duration and type, sex, and race/ethnicity.

Comparing antipsychotic treatments for schizophrenia: a health state approach.

The overall impact of first and second generation antipsychotics on quality of life and symptoms of people with schizophrenia remains controversial. We applied health state modeling to data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia study, a randomized trial of antipsychotic medications, and evaluated the likelihood of patients moving to more favorable health states over time. We applied K-means clustering to the data to create discrete groupings of patients with symptom and side effect characteristics that were then validated using quality of life measures.

Association of symptom severity, insight and increased pharmacologic side effects in acutely hospitalized patients with schizophrenia.

Background: Many studies have shown that more severe symptoms and poorer insight are associated with poor treatment compliance in schizophrenia while severe symptoms may result in higher medication dosages. Since pharmacologic side effects may accompany greater medication compliance and higher medication dosage, the relationship between symptoms, insight and side effects deserves study.

Methods: In this study, 174 inpatients diagnosed with schizophrenia were assessed during the week before hospital discharge from a large psychiatric hospital in Guangzhou, China.

Vietnam veteran perceptions of delayed onset and awareness of posttraumatic stress disorder.

Although 40 years have passed since the Vietnam War, demand for treatment of posttraumatic stress disorder (PTSD) among veterans from this conflict has increased steadily. This study investigates the extent to which two factors, delayed onset or awareness of PTSD symptoms, may influence this demand. Using data from two studies of Vietnam Veterans in outpatient (n = 353) and inpatient (n = 721) PTSD treatment, this analysis examines retrospective perceptions of the time of symptom onset and awareness of the connection between symptoms and war-zone stress.

Retrospective assessment of factors associated with readmission in a large psychiatric hospital in Guangzhou, China.

Background: Most psychiatric inpatients in China are involuntarily admitted by their families, resulting in relatively long admissions and relatively low readmission rates. However, this pattern may change after implementation of China's new national mental health law (promulgated in 2013), which restricts involuntary psychiatric admissions to the small proportion of mentally ill individuals who are a danger to self or others.

Aim: Assess the factors associated with readmission rates of psychiatric inpatients in Guangzhou, China.

Work outcomes after benefits counseling among veterans applying for service connection for a psychiatric condition.

Objective: This study's objective was to determine the efficacy of benefits counseling in a clinical trial. There has been concern that disability payments for psychiatric disorders reduce incentives for employment and rehabilitation. Benefits counseling, with education about opportunities to work and the financial implications of work on receipt of disability benefits, may counter these disincentives.

Attitudes towards people with mental illness among psychiatrists, psychiatric nurses, involved family members and the general population in a large city in Guangzhou, China.

Purpose: Stigma towards people with mental illness is believed to be widespread in low and middle income countries.

Methods: This study assessed the attitudes towards people with mental illness among psychiatrists, psychiatric nurses, involved family members of patients in a psychiatric facility and the general public using a standard 43-item survey (N = 535). Exploratory factor analysis identified four distinctive attitudes which were then compared using Analysis of Covariance (ANCOVA) among the four groups, all with ties to the largest psychiatric facility in Guangzhou, China, adjusting for sociodemographic differences.

Treatment of veterans with PTSD at a VA medical center: primary care versus mental health specialty care.

Objective: Recent military conflicts have generated significantly more demand for treatment of posttraumatic stress disorder (PTSD) as well as concerns about the adverse effects of stigma associated with specialty mental health care. This study examined the extent to which veterans diagnosed as having PTSD received treatment exclusively in primary care settings.

Methods: Administrative data from the U.

A cross-national factor analytic comparison of three models of PANSS symptoms in schizophrenia.

The 30-item Positive and Negative Syndrome Scale (PANSS) is used worldwide in the assessment of symptom severity in schizophrenia. The present study uses confirmatory factor analysis (CFA) to compare three different factorial models and to evaluate the best-fitting representation of schizophrenia symptom structure on the PANSS across four samples of patients diagnosed with schizophrenia from the US (the CATIE schizophrenia trial), São Paulo, Brazil, and from Beijing and Changsha, China. We examine the goodness of fit of several previously proposed models.