LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 444

Search options

  1. Article ; Online: Victimization in schizophrenia and its relation to violence.

    Buchanan, Alec / Stefanovics, Elina / Rosenheck, Robert

    Schizophrenia research

    2023  Volume 255, Page(s) 52–58

    Abstract: Background: People with schizophrenia are frequently victims of violence. Previous attempts to examine the reasons for this have mostly used cross-sectional designs that limit the ability to distinguish, among the correlates they identify, potential ... ...

    Abstract Background: People with schizophrenia are frequently victims of violence. Previous attempts to examine the reasons for this have mostly used cross-sectional designs that limit the ability to distinguish, among the correlates they identify, potential causes of victimization from its consequences.
    Method: We studied patients with schizophrenia participating in the NIMH-funded Clinical Antipsychotic Treatment for Intervention Effectiveness (CATIE) trial. The dependent variable was self-reported victimization during the 18-month CATIE follow-up. Independent variables were assessed at study entry and included demographics, childhood experiences, recent victimization and violent behavior, social circumstances, and mental health symptoms. Bivariate and multivariate analyses examined correlates of victimization and, among those victimized, the correlates of also acting violently oneself.
    Results: Of 1179 participants, 206 (17.5 %) reported one or more incidents where they were victimized over the 18-months. Over a third had been hit with a fist or an object. Most perpetrators were family or acquaintances. Controlling for other variables, victimization was associated with having been recently victimized at baseline as well as with sexual abuse in childhood, frequent interactions with close friends and depressive, but not schizophrenia, symptoms. Victimized participants who reported acting violently themselves (113; 55%) were more likely to report violent behavior at baseline and frequent interactions with close friends.
    Conclusions: Victimization in schizophrenia is often associated with aggressive behavior by the victim and is more often related to social involvement, past trauma, substance use and depression than to schizophrenia symptoms. Treatments that encourage socialization may incur an unintended risk of victimization.
    MeSH term(s) Humans ; Cross-Sectional Studies ; Violence/psychology ; Crime Victims/psychology ; Schizophrenia/epidemiology ; Sex Offenses
    Language English
    Publishing date 2023-03-22
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/j.schres.2023.03.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long-term opioid therapy and its deprescribing.

    Manhapra, Ajay / MacLean, R Ross / Rosenheck, Robert / Becker, William C

    British journal of clinical pharmacology

    2023  

    Abstract: A re-examination of clinical principles of long-term opioid therapy (LTOT) for chronic pain is long overdue amid the ongoing opioid crisis. Most patients on LTOT report ineffectiveness (poor pain control, function and health) but still find deprescribing ...

    Abstract A re-examination of clinical principles of long-term opioid therapy (LTOT) for chronic pain is long overdue amid the ongoing opioid crisis. Most patients on LTOT report ineffectiveness (poor pain control, function and health) but still find deprescribing challenging. Although prescribed as analgesics, opioids more likely provide pain relief primarily through reward system actions (enhanced relief and motivation) and placebo effect and less through antinociceptive effects. The unavoidable physiologic LTOT dependence can automatically lead to a paradoxical worsening of pain, disability and medical instability (maladaptive opioid dependence) without addiction due to allostatic opponent neuroadaptations involving reward/antireward and nociceptive/antinociceptive systems. This opioid-induced chronic pain syndrome (OICP) can persist/progress whether LTOT dose is maintained at the same level, increased, decreased or discontinued. Current conceptualization of LTOT as a straightforward long-term analgesic therapy appears incongruous in view of the complex mechanisms of opioid action, LTOT dependence and OICP. LTOT can be more appropriately conceptualized as therapeutic induction and maintenance of an adaptive LTOT dependence for functional improvement irrespective of analgesic benefits. Adaptive LTOT dependence should be ideally used for a limited time to achieve maximum functional recovery and deprescribed while maintaining functional gains. Patients on LTOT should be regularly re-evaluated to identify if maladaptive LTOT dependence with OICP has diminished any functional gains or leads to ineffectiveness. Ineffective LTOT (with maladaptive LTOT dependence) should be modified to make it safer and more effective. An adequately functional life without opioids is the ideal healthy long-term goal for both LTOT initiation and LTOT modification.
    Language English
    Publishing date 2023-11-22
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15972
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Commentary on Lin et al.: Saving lives during the opioid crisis-widening the focus from opioid use disorder to polysubstance use disorder and to multimorbidity.

    Manhapra, Ajay / Rosenheck, Robert

    Addiction (Abingdon, England)

    2020  Volume 116, Issue 1, Page(s) 105–106

    MeSH term(s) Buprenorphine ; Humans ; Multimorbidity ; Opioid Epidemic ; Opioid-Related Disorders/epidemiology ; Veterans Health
    Chemical Substances Buprenorphine (40D3SCR4GZ)
    Language English
    Publishing date 2020-09-11
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1141051-6
    ISSN 1360-0443 ; 0965-2140
    ISSN (online) 1360-0443
    ISSN 0965-2140
    DOI 10.1111/add.15229
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Does Street Outreach Engage Its Intended Target Population? Clinical Experience in the Veteran's Health Administration Homeless Service Programs.

    Lo, Emma / Tsai, Jack / Stefanovics, Elina A / Rosenheck, Robert

    The Psychiatric quarterly

    2022  Volume 93, Issue 4, Page(s) 1003–1016

    Abstract: Objective: Clinical street outreach programs serve people experiencing unsheltered homelessness, who have been shown to have greater medical and psychiatric comorbidities, and increased social and financial challenges. However, outreach programs may ... ...

    Abstract Objective: Clinical street outreach programs serve people experiencing unsheltered homelessness, who have been shown to have greater medical and psychiatric comorbidities, and increased social and financial challenges. However, outreach programs may struggle in practice to engage the most vulnerable of these individuals.
    Methods: Data from the Veterans Health Administration's (VHA's) Homeless Operations Management System (HOMES) from 2018 to 2019 (N = 101,998) were used to compare sociodemographic, clinical, and financial characteristics of literally homeless veterans contacted through street outreach to those who were self-referred or clinic-referred.
    Results: Veterans engaged through street outreach reported substantially more days of unsheltered homelessness in the past month (mean (M) = 11.18 days, s.d.=13.8) than the clinic-referred group (M = 6.75 days, s.d.=11.1), and were more likely to have spent the past 30 days unsheltered (RR = 2.23). There were notably few other differences between the groups.
    Conclusion: Despite epidemiologic evidence in the literature showing higher medical, psychiatric, and social and financial vulnerabilities among unsheltered homeless individuals, our street outreach group was not found to be any worse off on such variables than the clinic-referred or self-referred groups, other than increased time unsheltered. Outreach workers seem to engage more unsheltered individuals, but do not necessarily engage those with such severe vulnerabilities. Dedicated outreach program funding, training, and support are needed to support street outreach to those with the most severe problems.
    MeSH term(s) Humans ; Veterans ; Ill-Housed Persons ; Health Services ; Ambulatory Care Facilities ; Referral and Consultation
    Language English
    Publishing date 2022-11-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207521-0
    ISSN 1573-6709 ; 0033-2720
    ISSN (online) 1573-6709
    ISSN 0033-2720
    DOI 10.1007/s11126-022-10004-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: The association of opioid use disorder and homelessness nationally in the veterans health administration.

    Manhapra, Ajay / Stefanovics, Elina / Rosenheck, Robert

    Drug and alcohol dependence

    2021  Volume 223, Page(s) 108714

    Abstract: Background: Substance use disorder (SUD) is a major risk factor for homelessness, but the specific association of opioid use disorder (OUD) and homelessness in the context of their shared risk factors has not been the focus of prior studies. We used ... ...

    Abstract Background: Substance use disorder (SUD) is a major risk factor for homelessness, but the specific association of opioid use disorder (OUD) and homelessness in the context of their shared risk factors has not been the focus of prior studies. We used national data from the United States Veterans Health Administration (VHA) to examine the association of OUD and homelessness in the context of shared risk factors.
    Methods: In this cross-sectional analysis of veterans who received VHA care during Fiscal Year 2012 (N = 5,450,078), we compared the prevalence of OUD and other sociodemographic, and clinical factors among homeless and non-homeless veterans. We estimated the odds ratio for homelessness associated with OUD alone, and after adjusting for other factors through multivariate logistic regression.
    Results: Homeless veterans had substantially higher prevalence of OUD than other VHA patients (7.7 % Vs 0.6 %) and OUD was associated with 13 times higher unadjusted odds of homelessness (Odds Ratio [OR] 13.36, 95 % CI 13.09-13.62), which decreased with adjustment for sociodemographic factors (black race, mean income and age), other SUD, medical, and psychiatric diagnoses (final OR 1.57, 95 % CI 1.53-1.61). Other SUDs (alcohol, cannabis, cocaine, and hallucinogens) showed similar or slightly higher odds of homelessness as OUD in the final model.
    Conclusions: OUD was strongly associated with homelessness among US veterans although this association was largely but not entirely attenuated by shared sociodemographic and co-morbid risk factors including several other SUDs. Treatment of homeless veterans with OUD should address socio-economic vulnerabilities and other co-morbidities in addition to treatments for OUD.
    MeSH term(s) Cross-Sectional Studies ; Homeless Persons ; Humans ; Opioid-Related Disorders/epidemiology ; United States/epidemiology ; United States Department of Veterans Affairs ; Veterans ; Veterans Health
    Language English
    Publishing date 2021-04-14
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 519918-9
    ISSN 1879-0046 ; 0376-8716
    ISSN (online) 1879-0046
    ISSN 0376-8716
    DOI 10.1016/j.drugalcdep.2021.108714
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article: Second generation antipsychotics: evolution of scientific knowledge or uncovering fraud.

    Rosenheck, R

    Epidemiology and psychiatric sciences

    2013  Volume 22, Issue 3, Page(s) 235–237

    MeSH term(s) Antipsychotic Agents/therapeutic use ; Fraud ; Humans ; Schizophrenia
    Chemical Substances Antipsychotic Agents
    Language English
    Publishing date 2013-02-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2607964-1
    ISSN 2045-7979 ; 2045-7960
    ISSN (online) 2045-7979
    ISSN 2045-7960
    DOI 10.1017/S2045796012000662
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: An 18-month longitudinal study of suicidality in patients diagnosed with schizophrenia.

    Buchanan, Alec / Sint, Kyaw / Stefanovics, Elina / Rosenheck, Robert

    Schizophrenia research

    2020  Volume 224, Page(s) 102–107

    Abstract: Background: Suicide kills over 30,000 people annually in the US. Schizophrenia increases the risk, even in psychiatric populations. Identifying high-risk groups within this patient population is central to suicide prevention. We tested the effects of ... ...

    Abstract Background: Suicide kills over 30,000 people annually in the US. Schizophrenia increases the risk, even in psychiatric populations. Identifying high-risk groups within this patient population is central to suicide prevention. We tested the effects of known and putative risk factors for suicide in a clinically recognizable population with symptoms of schizophrenia and unstable illness.
    Methods: We studied 1439 subjects with schizophrenia participating in the NIMH-funded Clinical Antipsychotic Treatment for Intervention Effectiveness (CATIE) trial and followed for 18 months. The dependent variable was moderate to severe self-reported suicidal thinking and self-reported suicide attempts. The independent variables comprised potential risk factors for suicidality including measures of clinical change during follow-up. Proportional hazards models of time to first suicidality generated bivariate and multivariate hazard ratios (HRs).
    Results: Altogether 96 patients (7.6%) experienced moderate to severe suicidality in the course of 18 months. Multivariate analyses showed that baseline moderate or severe suicidality was the strongest correlate of subsequent moderate or severe suicidality (HR 5.1). An increase in a subject's depression score during follow-up was also independently and strongly associated with suicidality (HR 3.5). A change in psychotic symptoms was not.
    Conclusions: Depression and despair may be more important risk factors for suicidality among people with schizophrenia than psychotic decompensation. Strategies for prevention that seek to identify groups at high risk of suicide should focus on these variables, as well as the effect of prior suicidality.
    MeSH term(s) Humans ; Longitudinal Studies ; Risk Factors ; Schizophrenia/drug therapy ; Schizophrenia/epidemiology ; Suicidal Ideation ; Suicide ; Suicide, Attempted
    Language English
    Publishing date 2020-10-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/j.schres.2020.09.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Do Sex Differences Among Adults With Opioid Use Disorder Reflect Sex-specific Vulnerabilities? A Study of Behavioral Health Comorbidities, Pain, and Quality of Life.

    Rhee, Taeho Greg / Peltier, MacKenzie R / Sofuoglu, Mehmet / Rosenheck, Robert A

    Journal of addiction medicine

    2020  Volume 14, Issue 6, Page(s) 502–509

    Abstract: Objectives: Studies suggest that men and women have different vulnerabilities to a number of substance use disorders (SUDs). We examined whether differences between women and men with opioid use disorder (OUD) are significantly different from those ... ...

    Abstract Objectives: Studies suggest that men and women have different vulnerabilities to a number of substance use disorders (SUDs). We examined whether differences between women and men with opioid use disorder (OUD) are significantly different from those without OUD for selected sociodemographic and health outcomes.
    Methods: We used a cross-sectional survey design using data from 2012 to 2013 National Epidemiological Survey on Alcohol and Related Conditions Wave III, which surveyed nationally representative samples of non-institutionalized adults (n = 36,309 unweighted). Past-year OUD and other behavioral co-morbidities were defined using DSM-5 criteria. In bivariate analyses, we investigated sex differences in socio-demographic factors, behavioral co-morbidities, pain, and health-related quality of life (HRQOL) between women and men with past-year OUD, and then those without past-year OUD. We further used logistic regression analyses to evaluate interactions between effect of sex and past-year OUD status on behavioral co-morbidities, pain, and HRQOL.
    Results: When extrapolated, about 2.1 million US adults met diagnostic criteria for past-year OUD. Women with OUD had a higher likelihood of having several past-year psychiatric disorders, and a lower likelihood of having any past-year SUDs compared to male counterparts. However, similar relationships were observed among those without OUD and significant interaction effects were not found on behavioral co-morbidities, pain, and HRQOL, indicating that general sex differences are not specific to OUD.
    Conclusions: Although sex differences are not specific to OUD, concurrent disorders are not uncommon among women, as well as men, with OUD. There is a need to treat concurrent behavioral health conditions from a multimorbidity perspective in the treatment of OUD in both sexes.
    MeSH term(s) Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Opioid-Related Disorders/epidemiology ; Pain/epidemiology ; Quality of Life ; Sex Characteristics
    Language English
    Publishing date 2020-04-29
    Publishing country United States
    Document type Journal Article
    ISSN 1935-3227
    ISSN (online) 1935-3227
    DOI 10.1097/ADM.0000000000000662
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Tobacco Use Disorder Among Patients With Smoking-related Chronic Medical Disease: Association With Comorbid Substance Use Disorders.

    Manhapra, Ajay / Rosenheck, Robert

    Journal of addiction medicine

    2017  Volume 11, Issue 4, Page(s) 293–299

    Abstract: Introduction: Very little is known of the behavioral vulnerabilities of patients diagnosed with smoking-related chronic medical illness who continue to smoke, potentially worsening morbidity and mortality risks. This study explores the association of ... ...

    Abstract Introduction: Very little is known of the behavioral vulnerabilities of patients diagnosed with smoking-related chronic medical illness who continue to smoke, potentially worsening morbidity and mortality risks. This study explores the association of tobacco use disorder (TUD) among those with smoking-related chronic medical illnesses with other substance use disorders (SUDs) and risk factors.
    Methods: Among veterans with smoking-related chronic medical illnesses identified from the National Veterans Health Administration administrative records from fiscal year 2012, we compared the characteristics of those with a diagnosis of TUD (International Classification of Diseases, 9th edition code 305.xx; n = 519,918), and those without such a diagnosis (n = 2,691,840). Using multiple logistic regression, we further explored the independent association of factors associated with TUD.
    Results: SUD prevalence was markedly higher among those with TUD (24.9% vs 5.44%), including alcohol use disorder (20.4% vs 4.3%) and drug use disorder (13.5% vs 2.6%), compared with nonsmokers. On multiple logistic regression analyses, alcohol use disorder (odds ratio [OR] 2.94, 95% confidence interval [CI] 2.90-2.97) and drug use disorder (OR 1.97, 95% CI 1.94-1.99) were independently associated with current TUD diagnosis. Having any single SUD was associated with considerably high odds of having TUD (OR 3.32, 95% CI 3.29-2.36), and having multiple SUDs with even further increased risk (OR 4.09, 95% CI 4.02-4.16).
    Conclusions: A substantial proportion of people with TUD diagnosis despite concurrent smoking-related medical illnesses are also likely to have other comorbid SUDs, complicating efforts at smoking cessation, and requiring a broader approach than standard nicotine-dependence interventions.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ISSN 1935-3227
    ISSN (online) 1935-3227
    DOI 10.1097/ADM.0000000000000311
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: The association of recovery orientation and stigmatizing beliefs.

    Stacy, Meaghan A / Rosenheck, Robert

    Journal of mental health (Abingdon, England)

    2017  Volume 28, Issue 3, Page(s) 276–281

    Abstract: Background: Although mental health advocates and providers have promoted both recovery-oriented care and the de-stigmatization of mental illness, no studies have examined the interrelation of these two specific constructs.: Aims: This study aimed to ... ...

    Abstract Background: Although mental health advocates and providers have promoted both recovery-oriented care and the de-stigmatization of mental illness, no studies have examined the interrelation of these two specific constructs.
    Aims: This study aimed to evaluate this association, with the hypothesis that stronger perception of programmatic recovery orientation would be associated with less stigmatizing beliefs towards mental illness.
    Method: Veterans (N = 122) and mental health clinicians (N = 98) at a large Veterans Affairs Medical Center completed an assessment of recovery orientation and a measure of beliefs about mental illness.
    Results: Stronger endorsement of programmatic recovery orientation was associated with less stigmatizing attitudes in both groups. Each of the five factors on the recovery measure was significantly and negatively associated with each of the four factors on the stigma measure.
    Conclusions: Perspectives of recovery orientation and stigma are significantly, but negatively, associated. Future research should investigate the direction of causality behind these observed relationships, as this will provide the opportunity to identify potential interventions to increase recovery-oriented mental health care and reduce stigmatization.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Mental Disorders/prevention & control ; Mental Disorders/psychology ; Mental Health Recovery ; Middle Aged ; Social Stigma ; Stereotyping ; Veterans/psychology
    Language English
    Publishing date 2017-12-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 1145439-8
    ISSN 1360-0567 ; 0963-8237
    ISSN (online) 1360-0567
    ISSN 0963-8237
    DOI 10.1080/09638237.2017.1417573
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top