This study was a qualitative assessment of the effectiveness of therapeutic interventions used in the treatment of co-occurring disorders, Posttraumatic Stress Disorder (PTSD) and substance abuse. The qualitative assessment was an interview with a number of open ended questions and scales for the respondents to report preference. Interviews were conducted through the Wounded Warriors Project. Participants were males between the ages of 18 and 40, and were of multiple ethnicities. The interview questions primarily addressed whether or not the respondents received services and which services they felt were most beneficial. The interviews were anonymous and confidential, in the interest of preserving the privacy of the respondents. The results yielded by the data revealed that a small minority received services through the Veterans’ Association (VA), and were happy with the services they received. The majority of participants did not receive services through the VA for a variety of reasons which included long wait times, complicated administrative procedures, lack of transportation and lack of knowledge about which services were available. Veterans who did not receive services through the VA, received services through other venues, such as the Wounded Warrior Project (WWP). These services included medication, individual therapy, peer support groups and twelve step meetings. Data collected revealed that a combination of these services, used simultaneously, was more effective than one service or no services at all.

BACKGROUND: Elderly individuals with type 2 diabetes mellitus (T2DM) suffer from several comorbidities, which affect their health outcomes, as well as process of care. This study assessed process and intermediate clinical outcomes of diabetes care among elderly individuals with T2DM and co-occurring Parkinson's disease(PD). METHODS: This study used a retrospective cohort design with propensity score matching using Humana Medicare Advantage Part D claims database (2007-2011) and included elderly (age ≥ 65 years) Medicare beneficiaries with T2DM (identified by ICD-9-CM code of 250.x0 or 250.x2). PD was identified using ICD-9-CM code of 332.xx. After propensity score matching there were 2,703 individuals with T2DM and PD and 8,109 with T2DM and no PD. The three processes of care measures used in this study included: (i) HbA1c test; (ii) Lipid test; (iii) and Nephropathy screening. Intermediate clinical outcomes consisted of glycemic and lipid control. RESULTS: Multivariable conditional logistic regressions revealed that elderly individuals with T2DM and PD were 12 % (AOR: 0.88, 95 %CI: 0.79-0.97) and 18 % (AOR: 0.82, 95 %CI: 0.72-0.94) less likely to meet the annual American Diabetes Association (ADA) recommended HbA1c and lipid testing goals respectively compared to individuals with T2DM and no PD. Multinomial conditional logistic regressions showed that elderly individuals with T2DM and PD were more likely to have HbA1c and lipid (HbA1c < 8 %; LDL-C <100 mg/dl; HDL-C ≥ 50 mg/dl; triglyceride <150 mg/dl; and total cholesterol <200 mg/dl) control. CONCLUSIONS: Among elderly individuals with T2DM, those with PD were less likely to achieve ADA recommended annual HbA1c and lipid testing compared to those without PD. However, PD individuals were more likely to achieve intermediate glycemic and lipid control.

Despite our knowledge of environmental risk factors for psychopathology, the equifinality and multifinality observed in the extant literature reveals how little is known about the role of these risk factors in the development of psychopathology. The purpose of this study was to identify processes that differentiate internalizing, externalizing and co-occurring psychopathology. Specifically, emotion identification skill and cognitive appraisal style were examined as processes where individual differences may contribute to the development of mental illness. To date no study has been conducted to examine whether emotion identification and appraisal style may differentiate forms of internalizing, externalizing and co-occurring psychopathology and lack of clinically significant problems in one study. A better understanding of predictors or processes that differentiate forms of psychopathology may improve our understanding of developmental psychopathology as well as inform prevention and intervention efforts. One hundred and fifty eight participants were included in this study. Data supported emotion identification skill as important for predicting specific behavioral problem profiles. Implications for conceptualizations of psychopathology and directions for future studies are discussed.

Magister Curationis - MCur / As South Africa continues to experience the highest prevalence of HIV/AIDS globally, co-occurring mental illness poses challenges for public health. Mental illness has increased among people living with HIV/AIDS (PLWHA), as infected individuals succumb to the psychological stress and trauma of the disease. Key research issues, not yet well established, relate to whether professional nurses, working in psychiatric hospitals in South Africa, are equipped with the necessary knowledge and skills to be able to provide effective mental healthcare services, given the increase in mental illness of PLWHA. An increase in mental illness translates into an increase in demand for psychiatric services by PLWHA. There is a paucity of research on HIV/AIDS knowledge of professional nurses working in psychiatric hospitals in South Africa, despite the established acknowledgement of the increase of mental illness amongst PLWHA. The aim of this study was to assess the HIV/AIDS knowledge, attitude and perceived risks of professional nurses working in a psychiatric hospital in the Western Cape, South Africa. A quantitative, descriptive survey design, using an all-inclusive sampling method, was used to select 121 professional nurses employed at a psychiatric hospital in Western Cape to participate in the study. The objectives of the study were to: describe professional nurses’ knowledge of HIV/AIDS; describe the attitudes of professional nurses towards PLWHA and mental illness; and determine professional nurses’ perceived HIV risks in a psychiatric hospital.

No description available.

In view of the vast numbers of individuals with co-occurring mental health and substance use disorders within the offender population, the scarcity of research on the potential exacerbating effects of co-occurring disorders on prisoner misconduct is surprising. With a sample of 1,470 incarcerated women offenders in Pennsylvania, this study examined prisoner misconduct among four distinct groups: 1) inmates with co-occurring disorders, 2) those with mental illness only, 3) inmates with substance use disorders only, and 4) prisoners with no mental health or substance use disorders net the effects of other factors demonstrated in prior studies to influence institutional misconduct. Results suggested that female prisoners with mental health and co-occurring disorders were significantly more likely than those with no disorders to be charged with prison misconduct . Co-occurring disorder inmates were also more likely to be charged with both minor and serious misconduct compared to inmates with no disorders. The results of this study suggest that menttal health and co-occurring disorders may hinder the ability of some female offenders to successfully assimilate to the prison environment as evidenced by higher rates of institutional misbehavior. Practice and policy implications are discussed / Criminal Justice

No description available.

This exploratory, quantitative study investigated the prevalence rate of people with cooccurring substance-related and psychiatric disorders (CODs). A treatment-seeking sample from Houghton House Addiction Recovery Centre in Johannesburg, South Africa was used. Details of the case histories of the clients were collected, coded and analysed using Statistical Analysis System (SAS). The results indicated that 57.1% of 419 clients had one or more co-occurring psychiatric disorder, along with a substance-related disorder. Of the 239 with a COD, 155 had a mood disorder, 40 had an anxiety disorder, 39 had ADHD, 35 had an eating disorder, 8 had a conduct disorder and 5 had schizophrenia. Statistically significant relationships were found for ADHD with cannabis-related disorders and polysubstance dependence; anxiety-related disorders with alcohol-related disorders; and mood disorders with cocaine-related disorders, possibly substance-induced disorders and substance-induced disorders. These results showed that there was large group of people who presented for substance abuse treatment who have one or more COD. Having a COD made the nature of their problems particularly complex. There is a need for greater awareness of this vulnerable group. This would serve to improve the treatment that people with CODs receive.

Past literature has showed that there have been several misdiagnosis of mental illness due to client’s delays in speech or introspection caused by an intellectual disability. It is believed that the intellectual disability is either interfering with the proper mental health diagnosis or a mental health diagnosis is unnecessarily being added to an intellectual disability. The study used a qualitative design that asked four psychiatrists on how they are treating their clients with an intellectual disability in addition to their mental illness. The interview guide asks about the difficulty in diagnosing individuals with a mental illness and a co-occurring intellectual disability. The proportion of clients also having an intellectual disability and co-occurring mental illness ranged from 5 to 20%. The problems that psychiatrists are running into are the fact that patients are not being correctly diagnosed before the age of 18 and are not able to get the resources that are needed, such as Inland Regional services.

A specialized system of care for co-occurring clients can be an asset to this population, if the services offered deliver adequate results that contribute to the overall wellbeing of this community. Therefore, providers, including social workers and other professionals to determine the effectiveness of these programs, should routinely assess established programs that are design to meet the most basic needs of co-occurring populations. This will permit an increase the knowledge and understanding of outcomes and perhaps develop alternative resources to connect gaps in the delivery of services. This research evaluated the effectiveness of services that co-occurring clients received from Cedar House Life Change Center. It attempted to understand the correlation between graduation success and other variables, such as length in treatment, mental health and substance use diagnosis, types and frequency of services, and the effects of diverse populations on the treatment outcomes.