Homelessness predicts attrition but not alcohol abstinence in outpatients experiencing co-occurring alcohol dependence and serious mental illness.
Homelessness predicts attrition but not alcohol abstinence in outpatients experiencing co-occurring alcohol dependence and serious mental illness.
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DOI：
10.1080/08897077.2017.1391926
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发表时间：
2018
期刊：
影响因子：
3.5
通讯作者：
McDonell MG
中科院分区：
文献类型：
--
作者：
Leickly E;Skalisky J;Oluwoye O;McPherson SM;Srebnik D;Roll JM;Ries RK;McDonell MG
与居住稳定的成年人相比，无家可归和严重精神疾病(SMI)的成年人心理健康状况和治疗结果较差的风险更高。酒精滥用的额外问题使无家可归和精神障碍患者的生活变得更加复杂。在这个二次数据分析中，我们在一项奖励SMI门诊患者戒酒的应急管理(CM)干预中调查了无家可归对流失率和酒精使用的影响。通过乙基葡萄糖醛酸苷(EtG)尿液试验，对79名被诊断为酒精依赖和SMI的成年人进行了评估，评估了住房状况与治疗期间的磨耗和戒酒之间的关系。39%(n=31)的参与者报告在基线时无家可归。无家可归的人更有可能退出CM(n=10，62.5%)，比有住房的人(n=4，16.7%)更有可能退出CM，X2=(1)8.86，p<；0.05。在非偶发控制组中，无家可归与自然减员无关。考虑到治疗组和随机前的EtG水平，无论是住房状况的影响，还是住房状况和小组之间的相互作用，都与治疗期间EtG评估的酒精戒断有关。与那些住在房子里的人相比，无家可归、酒精依赖和接受CM治疗的SMI的人有更高的流失率。无家可归与生物学评估的戒酒情况的差异无关。
Adults experiencing homelessness and serious mental illnesses (SMI) are at an increased risk for poor mental health and treatment outcomes compared to stably housed adults with SMI. The additional problem of alcohol misuse further complicates the difficulties of those living with homelessness and SMI. In this secondary data analysis, we investigated the impact of homelessness on attrition and alcohol use in a contingency management (CM) intervention that rewarded alcohol abstinence in outpatients with SMI. The associations between housing status and attrition and alcohol abstinence during treatment, as assessed by ethyl glucuronide (EtG) urine tests, were evaluated in 79 adults diagnosed with alcohol dependence and SMI. Thirty-nine percent (n=31) of participants reported being homeless at baseline. Individuals who were homeless were more likely to drop out of CM (n=10, 62.5%), than those who were housed (n=4, 16.7%), X2 = (1) 8.86, p< 0.05. Homelessness was not associated with attrition in the non-contingent control group. Accounting for treatment group and pre-randomization EtG levels, neither the effect of housing status nor the interaction of housing status and group were associated with EtG-assessed alcohol abstinence during treatment. Individuals experiencing homelessness and co-occurring alcohol dependence and SMI receiving CM had higher rates of attrition, relative to those who were housed. Homelessness was not associated with differences in biologically assessed alcohol abstinence.
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影响因子：
3.8
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