Randomized Controlled Trial of Contingency Management for Stimulant Use in Community Mental Health Patients With Serious Mental Illness
| العنوان: | Randomized Controlled Trial of Contingency Management for Stimulant Use in Community Mental Health Patients With Serious Mental Illness |
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| المؤلفون: | Michael G. McDonell, Robert Short, Jessica M. Lowe, Frank Angelo, John M. Roll, Andrea Sugar, Richard K. Ries, Sterling McPherson, Debra Srebnik |
| المصدر: | American Journal of Psychiatry. 170:94-101 |
| بيانات النشر: | American Psychiatric Association Publishing, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, Male, Token Economy, Washington, medicine.medical_specialty, Bipolar Disorder, Patient Dropouts, Community Mental Health Centers, Substance-Related Disorders, medicine.medical_treatment, Contingency management, Comorbidity, Patient Readmission, law.invention, Cocaine dependence, Randomized controlled trial, Recurrence, law, medicine, Humans, Substance Abuse, Intravenous, Psychiatry, Depressive Disorder, Major, Motivation, Middle Aged, Mental illness, medicine.disease, Combined Modality Therapy, Mental health, Substance Abuse Detection, Stimulant, Substance abuse, Alcoholism, Psychiatry and Mental health, Psychotic Disorders, Schizophrenia, Central Nervous System Stimulants, Female, Schizophrenic Psychology, Psychology, Follow-Up Studies |
| الوصف: | The primary objective of this study was to determine whether contingency management was associated with increased abstinence from stimulant drug use in stimulant-dependent patients with serious mental illness treated in a community mental health center. Secondary objectives were to determine whether contingency management was associated with reductions in use of other substances, psychiatric symptoms, HIV risk behavior, and inpatient service utilization.A randomized controlled design was used to compare outcomes of 176 outpatients with serious mental illness and stimulant dependence. Participants were randomly assigned to receive 3 months of contingency management for stimulant abstinence plus treatment as usual or treatment as usual with reinforcement for study participation only. Urine drug tests and self report, clinician-report, and service utilization outcomes were assessed during the 3-month treatment period and the 3-month follow-up period.Although participants in the contingency management condition were significantly less likely to complete the treatment period than those assigned to the control condition (42% compared with 65%), they were 2.4 times (95% CI=1.9–3.0)more likely to submit a stimulant-negative urine test during treatment. Compared with participants in the control condition,they had significantly lower levels of alcohol use, injection drug use, and psychiatric symptoms and were one-fifth as likely as those assigned to the control condition to be admitted for psychiatric hospitalization during treatment. They also reported significantly fewer days of stimulant drug use during the 3-month follow-up.When added to treatment as usual, contingency management is associated with large reductions in stimulant,injection drug, and alcohol use.Reductions in psychiatric symptoms and hospitalizations are important secondary benefits. |
| تدمد: | 1535-7228 0002-953X |
| DOI: | 10.1176/appi.ajp.2012.11121831 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b6fc2fb6e72537056de9d8123a803371 https://doi.org/10.1176/appi.ajp.2012.11121831 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b6fc2fb6e72537056de9d8123a803371 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15357228 0002953X |
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| DOI: | 10.1176/appi.ajp.2012.11121831 |