Predictors of Retention in a Drug-Free Unit/substance Abuse Treatment in Prison.

Published May 28, 2013

Predictors of retention in a drug-free unit/substance abuse treatment in prison.

Int J Law Psychiatry. 2013 May 21;
Casares-López MJ, González-Menéndez A, Festinger DS, Fernández-García P, Fernández-Hermida JR, Secades R, Matejkowski J

The high rate of dropout from treatment programs is a recurring problem in the field of drug dependence. The purpose of this study was to identify the predictors of retention in a prison-based drug-free unit (DFU). The relationships among subscales of the Addiction Severity Index (ASI) as well as motivation and personality profiles and length of stay in a DFU, of 57 prisoners admitted for the first time to the program were analyzed. The mean dropout rates were 52.9% at six months and 67.8% at one year. The mean length of stay was 195.05days. Predictors of retention at six months included the ASI Family Composite Score, the motivation subscale Taking Steps, and Narcissistic personality trait score. Predictors of retention at one year included lower ASI Psychological Composite Score, higher scores on the motivation subscale Ambivalence, and higher number of charges pending at the time of admission to the program. Identification of these predictor variables may be useful for developing strategies to increase retention in the context of in-prison substance abuse treatment. HubMed – addiction

Antipsychotic response in first-episode schizophrenia: efficacy of high doses and switching.

Eur Neuropsychopharmacol. 2013 May 22;
Agid O, Schulze L, Arenovich T, Sajeev G, McDonald K, Foussias G, Fervaha G, Remington G

Clinicians treating schizophrenia routinely employ high doses and/or antipsychotic switching to achieve response. However, little is actually known regarding the value of these interventions in early schizophrenia. Data were gathered from a treatment algorithm implemented in patients with first-episode schizophrenia that employs two antipsychotic trials at increasing doses before clozapine. Patients were initially treated with either olanzapine or risperidone across three dose ranges, (low, full, high), and in the case of suboptimal response were switched to the alternate antipsychotic. We were interested in the value of (a) high dose treatment and (b) antipsychotic switching. A total of 244 patients were evaluated, with 74.5% (184/244) responsive to Trial 1, and only 16.7% (10/60) responsive to Trial 2. Percentage of response for subjects switched from olanzapine to risperidone was 4.0% (1/25) vs. 25.7% (9/35) for those switched from risperidone to olanzapine. High doses yielded a 15.5% response (14.6% for risperidone vs. 16.7% for olanzapine).The present findings concur with other research indicating that response rate to the initial antipsychotic trial in first-episode schizophrenia is robust; thereafter it declines notably. In general, the proportion of responders to antipsychotic switching and high dose interventions was low. For both strategies olanzapine proved superior to risperidone, particularly in the case of antipsychotic switching (i.e. risperidone to olanzapine vs. vice versa). It remains to be established whether further antipsychotic trials are associated with even greater decrements in rate of response. Findings underscore the importance of moving to clozapine when treatment resistance has been established. HubMed – addiction

Exploring the relationship between identity status development and alcohol consumption among Italian adolescents.

J Psychol. 2013 May-Jun; 147(3): 277-92
Laghi F, Baiocco R, Lonigro A, Baumgartner E

The main aim of this study was to explore the relationship between identity statuses and alcohol use and misuse in adolescence. A sample of 440 Italian students completed the Extended Objective Measure of Ego Identity Status-Version 2 (EOM-EIS-II) and the Alcohol Addiction Scale of the Shorter Promise Questionnaire (SPQ-ALC). The results suggested that problematic alcohol use during early and middle adolescence is associated with developmentally less sophisticated identity development. Foreclosed and diffused adolescents were classified as binge drinkers and heavy drinkers. The latter reported a higher mean dependence score than other identity groups. The risk and mediating factors about alcohol misuse and dependence are provided. HubMed – addiction