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      Psycho-education for substance use and antisocial personality disorder: a randomized trial

      research-article
      Author(s): , ,
      Publication date (Electronic):
      Journal: BMC Psychiatry
      Publisher: BioMed Central

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          Abstract

          Background

          Antisocial personality disorder often co-exists with drug and alcohol use disorders.

          Methods

          This trial examined the effectiveness of offering psycho-education for antisocial personality disorder in community substance use disorder treatment centers in Denmark. A total of 176 patients were randomly allocated to treatment as usual (TAU, n = 80) or TAU plus a psycho-educative program, Impulsive Lifestyle Counselling (ILC, n = 96) delivered by site clinicians ( n = 39). Using follow-up interviews 3 and 9 months after randomization, we examined changes in drug and alcohol use (Addiction Severity Index Composite Scores), percent days abstinent (PDA) within last month, and aggression as measured with the Buss-Perry Aggression Questionnaire-Short Form and the Self-Report of Aggression and Social Behavior Measure.

          Results

          Overall engagement in psychological interventions was modest: 71 (76 %) of participants randomized to psycho-education attended at least one counselling session, and 21 (23 %) attended all six sessions. The Median number of sessions was 2. All patients reduced drug and alcohol problems at 9 months with small within-group effect sizes. Intention-to-treat analyses indicated significant differences between ILC and TAU in mean drugs composite score ( p = .018) and in PDA ( p = .041) at 3 months. Aggression declined in both groups, but no differences between ILC and TAU were observed in terms of alcohol problems or aggression at any follow-up.

          Conclusions

          Moderate short-term improvements in substance use were associated with randomization to Impulsive Lifestyle Counselling. The findings support the usefulness of providing psycho-education to outpatients with antisocial personality disorder.

          Trial registration

          ISRCTN registry, ISRCTN67266318, 17/7/2012

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12888-015-0661-0) contains supplementary material, which is available to authorized users.

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          Most cited references46

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          Diagnostic and statistical manual of mental disorders.

          Vijay A. Mittal, Elaine Walker (2011)
          Article 0 comments Cited 3519 times – based on 0 reviews     Review now
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            Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood.

            David M. Fergusson, L John Horwood, Elizabeth M Ridder (2005)
            This paper seeks to extend research into the adult sequelae of childhood conduct problems by investigating the associations between conduct problems in middle childhood and psychosocial outcomes in adulthood. Data were gathered during the course of a 25-year longitudinal study of a birth cohort of New Zealand young people. Information was collected on: a) parent and teacher reports of child conduct problems at ages 7, 8 and 9 years; b) measures of crime, substance use, mental health, sexual/partner relationships, education/employment; c) confounding factors, including childhood, family and educational characteristics. There were statistically significant associations between childhood conduct problems from 7-9 years and risks of adverse outcomes across all domains of functioning. After control for confounding factors the associations between conduct problems and education/employment outcomes became statistically non-significant. Associations persisted for other outcomes (crime, substance dependence, mental health and sexual/partner relationships). Children in the most disturbed 5% of the cohort had rates of these outcomes that were between 1.5 and 19 times higher than rates for the least disturbed 50% of the cohort. The associations between conduct problems and adult outcomes were similar for males and females. Childhood conduct problems were associated with a wide range of adverse psychosocial outcomes (crime, substance use, mental health, sexual/partner relationships) even after control for confounding factors. The results reinforce the need for greater investment into interventions to address these problems.
            Article 0 comments Cited 236 times – based on 0 reviews     Review now
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              MINI International Neuropsychiatric Schedule: clinical utility and patient acceptance.

              N Pinninti, Harry Madison, D Rissmiller … (2003)
              Clinical diagnosis has been shown to be unreliable compared to structured diagnostic schedules. However, clinicians rarely use structured diagnostic schedules due to concerns about the feasibility in clinical practice and about patient acceptance. Mini International Neuropsychiatric Schedule is a short diagnostic instrument validated against SCID and CIDI but its feasibility and patient acceptance has not been studied. One hundred and eleven patients admitted to a partial program were administered Mini International Neuropsychiatric Schedule and the interview was timed. A short questionnaire was administered to assess patients' views about the interview. For a subgroup of patients, diagnoses by both open interviews and Mini International Neuropsychiatric Interview (MINI) were available. These were compared to look for agreement in primary diagnoses and co-morbid conditions. MINI took an average of 16.4 min to administer. Patients' views of MINI were positive. It was considered comprehensive enough to cover all patient symptoms and at the same time not unduly lengthy. Patients were not bothered by the interview format. There was disagreement between MINI primary diagnosis and open diagnosis in 42% cases. In 33% the disagreement was of substantial clinical significance. MINI diagnosed more co-morbid conditions (average 2.05 compared to 0.5 in open interview). MINI is a short diagnostic interview schedule that can be easily incorporated into routine clinical interviews. It has good acceptance by patients.
              Article 0 comments Cited 49 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Birgitte Thylstrup: bt.crf@psy.au.dk
                Sidsel Schrøder: ss.crf@psy.au.dk
                Morten Hesse: mh.crf@psy.au.dk
                Journal
                Journal ID (nlm-ta): BMC Psychiatry
                Journal ID (iso-abbrev): BMC Psychiatry
                Title: BMC Psychiatry
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-244X
                Publication date (Electronic): 14 November 2015
                Publication date PMC-release: 14 November 2015
                Publication date Collection: 2015
                Volume: 15
                Electronic Location Identifier: 283
                Affiliations
                Centre for Alcohol and Drug Research, Aarhus University, Artillerivej 90, 2nd, 2300 Copenhagen S, Denmark
                Article
                Publisher ID: 661
                DOI: 10.1186/s12888-015-0661-0
                PMC ID: 4647713
                PubMed ID: 26573140
                SO-VID: 52d24df3-52ca-4f96-87cf-9510eda550b7
                Copyright © © Thylstrup et al. 2015
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 23 July 2015
                Date accepted : 26 October 2015
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2015

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry

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