Separate Treatments Best For Comorbid Psychosis, Addiction

the Psychiatry Advisor take:

Patients with psychosis and addiction disorder may respond moderately better to disorder-specific treatment, according to research published in Deutsches Ärzteblatt International.

Addiction is a common problem for those with psychosis. Nearly one out of every two patients with schizophrenia develops an addiction disorder during their lifetime. The disorder often becomes chronic, and patients often have a poorer prognosis.

To determine whether disorder-specific treatment could improve patients’ motivation to remain abstinent and reduce their substance misuse, Euphrosyne Gouzoulis-Mayfrank, MD, from the University of Cologne, Germany, and colleagues studied 100 patients with psychosis and addiction who volunteered to be admitted to inpatient treatment for their disorders.

While all of the patients received standard treatment such as individual therapeutic sessions, therapy for their psychosis, and cognitive training, some patients also received disorder-specific group treatments that focused on psychoeducation and their motivation to remain abstinent from their addictions. They were then offered additional outpatient cognitive behavioral therapy.

After a year of treatment, the researchers found that patients who received disorder-specific treatment had a slightly stronger motivation to remain abstinent from their addiction and that their substance usage was slightly lower compared with the group who only received conventional treatment.

The authors stressed that this disorder-specific treatment will only yield moderate improvements in patients with psychosis and addiction disorder. Because the study had a limited number of participants, the researchers recommended verifying the results in larger studies and identifying subgroups that may be better responders to treatment.

Separate Treatments Best For Comorbid Psychosis, Addiction
Patients with psychosis and addiction disorders responded moderately better to disorder-specific treatment.

People with psychosis often develop an addiction disorder: almost one in two patients with schizophrenia are affected once during their lifetime. Patients with a dual diagnosis mostly have a poorer prognosis, and their disorder often becomes chronic.

Euphrosyne Gouzoulis-Mayfrank and colleagues investigated in a randomized controlled study in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2015; 112: 683-91) whether disorder-specific treatment can improve patients' motivation to remain abstinent and reduce their substance misuse. They applied an evaluated therapeutic program that would be easy to implement in standard care.

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