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Recent Advances in Dual Disorders (Addiction and Other Mental Disorders)

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (10 October 2022) | Viewed by 28747

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Prof. Dr. Marta Torrens

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1. Department of Psychiatry, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
2. Neuroscience Research Program-IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
3. Addiction Program-Hospital del Mar, 08003 Barcelona, Spain
Interests: substance use disorders; dual disorders; gender perspective; new psychoactive substances
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Prof. Dr. Ana Adan

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Guest Editor

1. Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035 Barcelona, Spain
2. Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
Interests: substance use; dual disorders; chronobiology; circadian rhythms; neurocognition; severe mental illness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

In September 2019, our Special Issue “Diagnosis and Management of Addiction and Other Mental Disorders (Dual Disorders)” was launched (https://www.mdpi.com/journal/jcm/special_issues/Addiction_Dual_Disorders). A number of papers on different topics, from basic to clinical perspectives, were published with a very positive impact on scientists and professionals on the subject.

The individual, social, and public health impact of dual disorders (the co-occurrence of drug use disorders with other mental health conditions) is extremely high, and a multidisciplinary and comprehensive response to the needs of persons with these disorders is required. Unfortunately, there are many gaps in the global system, which is ill-prepared to meet this challenge. The percentage of patients suffering from dual disorders is high, and in recent years, the epidemiological data have been steadily increasing. This is occurring in parallel with evidence of greater difficulties in both clinical management and stabilization of these patients compared to those with only one disorder (e.g., increases admissions in emergency rooms, hospitalizations, suicide).

The COVID-19 pandemic has already had a negative impact on mental health, especially in the young population, thus leading to the detection of both substance and behavioral addictions and many other mental disorders (major depression, anxiety, eating disorders, etc.). All of this is taking place in health systems that are already traditionally under pressure in the field of mental health, regardless of the country and model of care, and where there is a need for specialized centers and professionals trained in the management of dual disorders. This situation will only be overcome with rigorous work from multiple approaches (biological, psychological, social) that allows for interdisciplinary integration that will lead to future advances in knowledge and to overcoming of the deficits that exist today and new opportunities to improve them.

Given the success of our first Special Issue, we believe that it is time to launch a second Special Issue aimed at compiling recent advances in dual disorders, considering different levels of approach that provide interesting data with a view to being transferred as soon as possible to healthcare. In this sense, consensus papers, expert reviews and study protocols are also welcome. Methodologically sound research with valid and reliable procedures is a prerequisite for acceptance.

We welcome both solicited and unsolicited submissions that will contribute to this goal.

Prof. Dr. Marta Torrens
Prof. Dr. Ana Adan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Dual disorders
Substance use disorders
Addictive disorders
Psychiatric comorbidity
Risk factors
Clinical predictors
Endophenotypes
Treatment
COVID-19 impact

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Diagnosis and Management of Addiction and Other Mental Disorders (Dual Disorders) in Journal of Clinical Medicine (13 articles)

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Editorial

Jump to: Research

4 pages, 200 KiB

Open AccessEditorial

Recent Advances in Dual Disorders (Addiction and Other Mental Disorders)

by Marta Torrens and Ana Adan

J. Clin. Med. 2023, 12(9), 3315; https://doi.org/10.3390/jcm12093315 - 6 May 2023

Cited by 5 | Viewed by 1591

Abstract

In clinical mental health practice, the presence of Dual Disorders (DDs), defined as the comorbidity of at least one Substance Use Disorder (SUD) and another mental disorder in the same person [...] Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

Research

Jump to: Editorial

18 pages, 630 KiB

Open AccessArticle

Differential Effects of Patient Navigation across Latent Profiles of Barriers to Care among People Living with HIV and Comorbid Conditions

by Sharleen M. Traynor, Renae D. Schmidt, Lauren K. Gooden, Tim Matheson, Louise Haynes, Allan Rodriguez, Michael Mugavero, Petra Jacobs, Raul Mandler, Carlos Del Rio, Adam W. Carrico, Viviana E. Horigian, Lisa R. Metsch and Daniel J. Feaster

J. Clin. Med. 2023, 12(1), 114; https://doi.org/10.3390/jcm12010114 - 23 Dec 2022

Cited by 5 | Viewed by 2095

Abstract

Engaging people living with HIV who report substance use (PLWH-SU) in care is essential to HIV medical management and prevention of new HIV infections. Factors associated with poor engagement in HIV care include a combination of syndemic psychosocial factors, mental and physical comorbidities, and structural barriers to healthcare utilization. Patient navigation (PN) is designed to reduce barriers to care, but its effectiveness among PLWH-SU remains unclear. We analyzed data from NIDA Clinical Trials Network’s CTN-0049, a three-arm randomized controlled trial testing the effect of a 6-month PN with and without contingency management (CM), on engagement in HIV care and viral suppression among PLWH-SU (n = 801). Latent profile analysis was used to identify subgroups of individuals’ experiences to 23 barriers to care. The effects of PN on engagement in care and viral suppression were compared across latent profiles. Three latent profiles of barriers to care were identified. The results revealed that PN interventions are likely to be most effective for PLWH-SU with fewer, less severe healthcare barriers. Special attention should be given to individuals with a history of abuse, intimate partner violence, and discrimination, as they may be less likely to benefit from PN alone and require additional interventions. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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12 pages, 1036 KiB

Open AccessArticle

Suicidality as a Predictor of Overdose among Patients with Substance Use Disorders

by Viviana E. Horigian, Renae D. Schmidt, Dikla Shmueli-Blumberg, Kathryn Hefner, Judith Feinberg, Radhika Kondapaka, Daniel J. Feaster, Rui Duan, Sophia Gonzalez, Carly Davis, Rodrigo Marín-Navarrete and Susan Tross

J. Clin. Med. 2022, 11(21), 6400; https://doi.org/10.3390/jcm11216400 - 29 Oct 2022

Cited by 4 | Viewed by 2414

Abstract

Increasing rates of overdose and overdose deaths are a significant public health problem. Research has examined co-occurring mental health conditions, including suicidality, as a risk factor for intentional and unintentional overdose among individuals with substance use disorder (SUD). However, this research has been limited to single site studies of self-reported outcomes. The current research evaluated suicidality as a predictor of overdose events in 2541 participants who use substances enrolled across eight multi-site clinical trials completed within the National Drug Abuse Treatment Clinical Trials Network between 2012 to 2021. The trials assessed baseline suicidality with the Concise Health Risk Tracking Self-Report (CHRT-SR). Overdose events were determined by reports of adverse events, cause of death, or hospitalization due to substance overdose, and verified through a rigorous adjudication process. Multivariate logistic regression was performed to assess continuous CHRT-SR score as a predictor of overdose, controlling for covariates. CHRT-SR score was associated with overdose events (p = 0.03) during the trial; the likelihood of overdose increased as continuous CHRT score increased (OR 1.02). Participants with lifetime heroin use were more likely to overdose (OR 3.08). Response to the marked rise in overdose deaths should integrate suicide risk reduction as part of prevention strategies. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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12 pages, 739 KiB

Open AccessArticle

Exploring the Association between Gambling-Related Offenses, Substance Use, Psychiatric Comorbidities, and Treatment Outcome

by Cristina Vintró-Alcaraz, Gemma Mestre-Bach, Roser Granero, Elena Caravaca, Mónica Gómez-Peña, Laura Moragas, Isabel Baenas, Amparo del Pino-Gutiérrez, Susana Valero-Solís, Milagros Lara-Huallipe, Bernat Mora-Maltas, Eduardo Valenciano-Mendoza, Elías Guillen-Guzmán, Ester Codina, José M. Menchón, Fernando Fernández-Aranda and Susana Jiménez-Murcia

J. Clin. Med. 2022, 11(16), 4669; https://doi.org/10.3390/jcm11164669 - 10 Aug 2022

Cited by 7 | Viewed by 2233

Abstract

Several studies have explored the association between gambling disorder (GD) and gambling-related crimes. However, it is still unclear how the commission of these offenses influences treatment outcomes. In this longitudinal study we sought: (1) to explore sociodemographic and clinical differences (e.g., psychiatric comorbidities) between individuals with GD who had committed gambling-related illegal acts (differentiating into those who had had legal consequences (n = 31) and those who had not (n = 55)), and patients with GD who had not committed crimes (n = 85); and (2) to compare the treatment outcome of these three groups, considering dropouts and relapses. Several sociodemographic and clinical variables were assessed, including the presence of substance use, and comorbid mental disorders. Patients received 16 sessions of cognitive-behavioral therapy. Patients who reported an absence of gambling-related illegal behavior were older, and showed the lowest GD severity, the most functional psychopathological state, the lowest impulsivity levels, and a more adaptive personality profile. Patients who had committed offenses with legal consequences presented the highest risk of dropout and relapses, higher number of psychological symptoms, higher likelihood of any other mental disorders, and greater prevalence of tobacco and illegal drugs use. Our findings uphold that patients who have committed gambling-related offenses show a more complex clinical profile that may interfere with their adherence to treatment. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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12 pages, 537 KiB

Open AccessArticle

Changes in the Care Activity in Addiction Centers with Dual Pathology Patients during the COVID-19 Pandemic

by Cinta Mancheño-Velasco, Daniel Dacosta-Sánchez, Andrea Blanc-Molina, Marta Narvaez-Camargo and Óscar Martín Lozano-Rojas

J. Clin. Med. 2022, 11(15), 4341; https://doi.org/10.3390/jcm11154341 - 26 Jul 2022

Cited by 3 | Viewed by 1860

Abstract

Background: Health care provision during the COVID-19 pandemic and confinement has led to significant changes in the activity of addiction centers. These changes in healthcare activity may have had a greater impact on patients with dual pathology. The aim of this study is to compare the treatment indicators of patients with dual pathology in addiction centers during the pre-confinement, confinement, and post-confinement periods. Methods: A retrospective observational study was conducted for the period between 1 February 2019 and 30 June 2021. A total of 2785 patients treated in specialized addiction services were divided into three periods according to their time of admission: pre-confinement, confinement, and post-confinement. Results: During the pre-pandemic period, the addiction centers attended to an average of 121.3 (SD = 23.58) patients, decreasing to 53 patients during confinement (SD = 19.47), and 80.69 during the post-confinement period (SD = 15.33). The number of appointments scheduled monthly for each patient decreased during the confinement period, although this number increased after confinement. There was a reduction in the number of toxicological tests carried out both during and after confinement (except for alcohol). Conclusions: The results show a reduction in the number of patients seen and the care activity delivered to dual diagnosis patients. These results, which were caused by the COVID-preventive measures, may affect the progress and recovery of dual patients. A greater investment is needed to bring the care activity up to the standards of the years prior to confinement. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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13 pages, 795 KiB

Open AccessArticle

Machine Learning Prediction of Comorbid Substance Use Disorders among People with Bipolar Disorder

by Vincenzo Oliva, Michele De Prisco, Maria Teresa Pons-Cabrera, Pablo Guzmán, Gerard Anmella, Diego Hidalgo-Mazzei, Iria Grande, Giuseppe Fanelli, Chiara Fabbri, Alessandro Serretti, Michele Fornaro, Felice Iasevoli, Andrea de Bartolomeis, Andrea Murru, Eduard Vieta and Giovanna Fico

J. Clin. Med. 2022, 11(14), 3935; https://doi.org/10.3390/jcm11143935 - 6 Jul 2022

Cited by 10 | Viewed by 3306

Abstract

Substance use disorder (SUD) is a common comorbidity in individuals with bipolar disorder (BD), and it is associated with a severe course of illness, making early identification of the risk factors for SUD in BD warranted. We aimed to identify, through machine-learning models, the factors associated with different types of SUD in BD. We recruited 508 individuals with BD from a specialized unit. Lifetime SUDs were defined according to the DSM criteria. Random forest (RF) models were trained to identify the presence of (i) any (SUD) in the total sample, (ii) alcohol use disorder (AUD) in the total sample, (iii) AUD co-occurrence with at least another SUD in the total sample (AUD+SUD), and (iv) any other SUD among BD patients with AUD. Relevant variables selected by the RFs were considered as independent variables in multiple logistic regressions to predict SUDs, adjusting for relevant covariates. AUD+SUD could be predicted in BD at an individual level with a sensitivity of 75% and a specificity of 75%. The presence of AUD+SUD was positively associated with having hypomania as the first affective episode (OR = 4.34 95% CI = 1.42–13.31), and the presence of hetero-aggressive behavior (OR = 3.15 95% CI = 1.48–6.74). Machine-learning models might be useful instruments to predict the risk of SUD in BD, but their efficacy is limited when considering socio-demographic or clinical factors alone. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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17 pages, 478 KiB

Open AccessArticle

Lifetime Dual Disorder Screening and Treatment Retention: A Pilot Cohort Study

by Beatriz Puértolas-Gracia, María Gabriela Barbaglia, Mercè Gotsens, Oleguer Parés-Badell, María Teresa Brugal, Marta Torrens, Lara Treviño, Concepción Rodríguez-Díaz, José María Vázquez-Vázquez, Alicia Pascual, Marcela Coromina-Gimferrer, Míriam Jiménez-Dueñas, Israel Oliva, Erick González, Nicanor Mestre and Montse Bartroli

J. Clin. Med. 2022, 11(13), 3760; https://doi.org/10.3390/jcm11133760 - 28 Jun 2022

Cited by 3 | Viewed by 2039

Abstract

The coexistence of a substance use disorder and another mental disorder in the same individual has been called dual disorder or dual diagnosis. This study aimed to examine the prevalence of lifetime dual disorder in individuals with alcohol or cocaine use disorder and their retention in treatment. We conducted a pilot cohort study of individuals (n = 1356) with alcohol or cocaine use disorder admitted to treatment in the public outpatient services of Barcelona (Spain) from January 2015 to August 2017 (followed-up until February 2018). Descriptive statistics, Kaplan–Meier survival curves and a multivariable Cox regression model were estimated. The lifetime prevalence of screening positive for dual disorder was 74%. At 1 year of follow-up, >75% of the cohort remained in treatment. On multivariable analysis, the factors associated with treatment dropout were a positive screening for lifetime dual disorder (HR = 1.26; 95% CI = 1.00–1.60), alcohol use (HR = 1.35; 95% CI = 1.04–1.77), polysubstance use (alcohol or cocaine and cannabis use) (HR = 1.60; 95% CI = 1.03–2.49) and living alone (HR = 1.34; 95% CI = 1.04–1.72). Lifetime dual disorder is a prevalent issue among individuals with alcohol or cocaine use disorders and could influence their dropout from treatment in public outpatient drug dependence care centres, along with alcohol use, polysubstance use and social conditions, such as living alone. We need a large-scale study with prolonged follow-up to confirm these preliminary results. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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16 pages, 1812 KiB

Open AccessArticle

Bridge Nodes between Personality Traits and Alcohol-Use Disorder Criteria: The Relevance of Externalizing Traits of Risk Taking, Callousness, and Irresponsibility

by Ana De la Rosa-Cáceres, Marta Narvaez-Camargo, Andrea Blanc-Molina, Nehemías Romero-Pérez, Daniel Dacosta-Sánchez, Bella María González-Ponce, Alberto Parrado-González, Lidia Torres-Rosado, Cinta Mancheño-Velasco and Óscar Martín Lozano-Rojas

J. Clin. Med. 2022, 11(12), 3468; https://doi.org/10.3390/jcm11123468 - 16 Jun 2022

Cited by 5 | Viewed by 2830

Abstract

Background: Personality disorders show strong comorbidities with alcohol-use disorder (AUD), and several personality traits have been found to be more frequent in people with AUD. This study analyzes which personality facets of those proposed in the Alternative Model of Personality Disorder (AMPD) of DSM-5 are associated with the diagnostic criteria of AUD. Methods: The sample was composed of 742 participants randomly selected from the Spanish population, and 243 patients attending mental health services. All participants were of legal age and signed an informed consent form. The instruments were administered to the community sample in an online format, and a psychologist conducted individual face-to-face interviews with the patients. AMPD facets were assessed through the Personality Inventory of DSM-5 Short-Form, and the AUD criteria through the Substance Dependence Severity Scale. A network analysis was applied to identify the personality facets mostly associated with the AUD criteria. Results: The network analysis showed the existence of three communities, grouping the AUD criteria, externalizing spectrum facets, and internalizing spectrum facets, respectively. Risk taking, callousness, and irresponsibility facets showed the strongest association with the AUD criteria, bridging externalizing personality traits with AUD criteria. Conclusions: The facets of risk taking, callousness, and irresponsibility should be accurately assessed in patients with AUD to differentiate between a possible primary personality disorder and a syndrome induced by alcohol addiction. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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19 pages, 724 KiB

Open AccessArticle

Protocol for Characterization of Addiction and Dual Disorders: Effectiveness of Coadjuvant Chronotherapy in Patients with Partial Response

by Ana Adan, José Francisco Navarro and on behalf of ADDISCHRONO Group

J. Clin. Med. 2022, 11(7), 1846; https://doi.org/10.3390/jcm11071846 - 26 Mar 2022

Cited by 4 | Viewed by 2398

Abstract

This protocol aims to characterize patients with dual disorders (DD; comorbid major depression and schizophrenia) compared with patients with only a diagnosis of substance use disorder (SUD) and those with only a diagnosis of severe mental illness (SMI; major depression and schizophrenia), evaluating clinical and personality characteristics, circadian rhythmic functioning, genetic polymorphism and neuropsychological performance in order to obtain a clinical endophenotype of differential vulnerability for these diagnostic entities. Patients will be divided into three groups: DD (45 men with comorbid schizophrenia, 45 men and 30 women with major depression), SUD (n = 90, with a minimum of 30 women) and SMI males (45 with schizophrenia, 45 with major depression). All patients will be under treatment, with at least three months of SUD abstinence and/or with SMI in remission or with stabilized symptoms. Outpatients of both sexes with insufficient restoration of circadian rhythmicity with SUD (n = 30) and dual depression (n = 30) will be asked to participate in a second two-month study, being alternately assigned to the condition of the chronobiological adjuvant approach to the treatment of regular hour habits and exposure to light or to the usual treatment (control). The effect of the intervention and patient compliance will be monitored with a Kronowise KW6^® ambulatory device during the first two weeks of treatment and again at weeks 4 and 8 weeks. After completing the evaluation, follow-up of the clinical evolution will be carried out at 3, 6 and 12 months. This project will allow us to analyze the functional impact of DD comorbidity and to develop the first study of chronobiological therapy in the treatment of SUD and dual depression, with results transferable to the clinical setting with cost-effective recommendations for a personalized approach. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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9 pages, 1125 KiB

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Dual Disorders in the Consultation Liaison Addiction Service: Gender Perspective and Quality of Life

by Teresa Ferrer-Farré, Fernando Dinamarca, Joan Ignasi Mestre-Pintó, Francina Fonseca and Marta Torrens

J. Clin. Med. 2021, 10(23), 5572; https://doi.org/10.3390/jcm10235572 - 26 Nov 2021

Cited by 4 | Viewed by 2373

Abstract

Dual disorders (DD) and gender differences comprise an area of considerable concern in patients with substance use disorder (SUD). This study aims to describe the presence of DD among patients with SUD admitted to a general hospital and attended by a consultation liaison addiction service (CLAS), in addition to assessing its association with addiction severity and quality of life from a gender perspective, between 1 January and 30 September 2020. The dual diagnosis screening interview (DDSI), the severity of dependence scale (SDS), and the WHO well-being index were used to evaluate the patients. In the overall sample, DD prevalence was 36.8%, (women: 53.8% vs. men: 32.7%, NS). In both genders the most prevalent DD was depression (33.8%, women: 46.2% vs. men: 30.9%, p = 0.296). Women presented more panic disorders (46.2% vs. 12.7%, p = 0.019) and generalized anxiety (38.5% vs. 10.9%, p = 0.049) than men. When DD was present, women had worse quality of life than men (21.7 vs. 50 points, p = 0.02). During lockdown period 77 patients were attended to and 13 had COVID-19 infection, with no differences in relation to sociodemographic and consumption history variables. The study confirms a high prevalence of DD among patients with SUD admitted to a general hospital for any pathology, and its being associated with worse quality of life, particularly in women. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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16 pages, 1199 KiB

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Circadian Characteristics in Patients under Treatment for Substance Use Disorders and Severe Mental Illness (Schizophrenia, Major Depression and Bipolar Disorder)

by Ana Belén Serrano-Serrano, Julia E. Marquez-Arrico, José Francisco Navarro, Antonio Martinez-Nicolas and Ana Adan

J. Clin. Med. 2021, 10(19), 4388; https://doi.org/10.3390/jcm10194388 - 25 Sep 2021

Cited by 18 | Viewed by 3212

Abstract

Dual disorders (substance use and mental illness comorbidity) are a condition that has been strongly associated with severe symptomatology and clinical complications. The study of circadian characteristics in patients with Severe Mental Illness or Substance Use Disorder (SUD) has shown that such variables are related with mood symptoms and worse recovery. In absence of studies about circadian characteristics in patients with dual disorders we examined a sample of 114 male participants with SUD and comorbid Schizophrenia (SZ+; n = 38), Bipolar Disorder (BD+; n = 36) and Major Depressive Disorder (MDD+; n = 40). The possible differences in the sample of patients according to their psychiatric diagnosis, circadian functioning with recordings of distal skin temperature during 48 h (Thermochron iButton^®), circadian typology and sleep-wake schedules were explored. MDD+ patients were more morning-type, while SZ+ and BD+ had an intermediate-type; the morning-type was more frequent among participants under inpatient SUD treatment. SZ+ patients had the highest amount of sleeping hours, lowest arousal and highest drowsiness followed by BD+ and MDD+, respectively. These observed differences suggest that treatment for patients with dual disorders could include chronobiological strategies to help them synchronize patterns with the day-light cycle, since morning-type is associated with better outcomes and recovery. Full article

(This article belongs to the Special Issue Recent Advances in Dual Disorders (Addiction and Other Mental Disorders))

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