Contingency management for patients with dual disorders in intensive outpatient treatment for addiction.
Contingency management for patients with dual disorders in intensive outpatient treatment for addiction.
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DOI：
10.1080/15504263.2014.924772
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发表时间：
2014
影响因子：
2.2
通讯作者：
Douaihy AB
中科院分区：
文献类型：
--
作者：
Kelly TM;Daley DC;Douaihy AB
本项目调查了应急管理的有效性，以提高双重障碍患者在强化门诊戒毒治疗中的治疗保留率和积极结果。在一个部分住院计划中，对160名接受应急管理的患者(n=88)和没有接受应急管理的患者(n=72)进行了应急管理效果的探讨。根据《美国精神病学协会诊断和统计手册》(DSM-IV-TR)，精神病学家和专科临床医生对因治疗药物使用和共病精神障碍而部分住院的患者进行诊断。在本报告中使用了应急管理“鱼缸”方法的独特应用，以提高每周五天患者参加治疗的一致性。接受治疗的天数和戒毒天数是主要的结果变量。其他令人感兴趣的结果包括抑郁、焦虑和心理压力、应对能力和药物渴望的强度。与非应急管理组患者相比，应急管理组患者接受治疗的天数分别为16.2天(SD=10.0)和9.9天(SD=8.5)；t=4.2，df=158，p<；治疗组之间在戒毒天数方面没有发现差异。心理压力和对毒品的渴求与戒毒天数呈负相关(r=−.18，p<；0.02；r=−.31，p<；.001)。治疗天数和对药物的渴求与多因素检验中停药天数相关(B=0.05，SE=0.01，β=0.39，t=4.9，p<；.001；B=−.47SE=.12，β=−.30，t=−3.9，p<；.001；调整R2=.21)。接受治疗的天数部分地调节了暴露于应急管理和自我报告的无毒天数之间的关系。在部分住院治疗的双重障碍患者中，应急管理是增加治疗保留率的有价值的辅助手段。接受应急管理会增加治疗的保留率，这反过来又会增加无毒天数。强化双重诊断组治疗应重视心理应激和药物渴求的干预。
This project investigated the effectiveness of contingency management for improving retention in treatment and positive outcomes among patients with dual disorders in intensive outpatient treatment for addiction. The effect of contingency management was explored among a group of 160 patients exposed to contingency management (n = 88) and not exposed to contingency management (no contingency management, n = 72) in a partial hospitalization program. Patients referred to the partial hospitalization program for treatment of substance use and comorbid psychiatric disorders were diagnosed by psychiatrists and specialist clinicians according to the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV-TR). A unique application of the contingency management “fishbowl” method was used in the to improve consistency of attendance at treatment sessions, which patients attended five days a week. Days attending treatment and drug-free days were the main outcome variables. Other outcomes of interest were depression, anxiety and psychological stress, coping ability, and intensity of drug cravings. Patients in the contingency management group attended more treatment days compared to patients in the no contingency management group; M = 16.2 days (SD = 10.0) vs. M = 9.9 days (SD = 8.5), respectively; t = 4.2, df = 158, p<.001. No difference was found between the treatment groups on number of drug-free days. Psychological stress and drug craving were inversely associated with drug-free days in bivariate testing (r =−.18, p<.02; r = −.31, p<.001 respectively). Treatment days attended and drug craving were associated with drug-free days in multivariate testing (B = .05, SE =.01, β = .39, t =4.9, p <.001; B = −.47 SE = .12, β = −.30, t =−3.9, p <.001; respectively; Adj. R2 = .21). Days attending treatment partially mediated the relationship between exposure to contingency management and self-reported drug-free days. Contingency management is a valuable adjunct for increasing retention in treatment among patients with dual disorders in partial hospitalization treatment. Exposure to contingency management increases retention in treatment, which in turn contributes to increased drug-free days. Interventions for coping with psychological stress and drug cravings should be emphasized in intensive dual diagnosis group therapy.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
2.7
作者：
Kimberlin, Carole L.;Winterstein, Almut G.
通讯作者：
Winterstein, Almut G.
影响因子：
3.9
作者：
Bell, DC;Atkinson, JS;Spence, RT
通讯作者：
Spence, RT
DOI：
10.1016/0005-7916(90)90008-9
发表时间：
1990-09-01
影响因子：
1.8
作者：
CAREY, KB;CAREY, MP
通讯作者：
CAREY, MP
影响因子：
6
作者：
Humphreys, Keith;McLellan, A. Thomas
通讯作者：
McLellan, A. Thomas