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National Collaborating Centre for Mental Health (UK). Psychosis with Coexisting Substance Misuse: Assessment and Management in Adults and Young People. Leicester (UK): British Psychological Society (UK); 2011. (NICE Clinical Guidelines, No. 120.)
Psychosis with Coexisting Substance Misuse: Assessment and Management in Adults and Young People.
Show detailsWhere available, data were extracted from the review developed for the Cochrane Collaboration by Cleary and colleagues (Cleary, M., Hunt, G. E., Matheson, S. L., et al. [2008] Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database of Systematic Reviews, Issue 1. DOI: 10.1002/14651858.CD001088.pub2), otherwise from the original study publication (see Appendix 13 for further details about each study).
Service delivery models
1. INTEGRATED SERVICEMODELS versus NON-INTEGRATED SERVICEMODELS (critical outcomes)
1.1. versus Standard care - Substance use: 1. Substance use rating (high=poor)
1.2. versus Standard care - Substance use: 2. Days used substances
1.3. versus Standard care - Service use: 1. Days in stable community residences (not in hospital)
1.4. versus Non-integrated ACT - Substance use: 1. Substance use rating (high=poor)
1.5. versus Non-integrated ACT - Substance use: 2. Days used substances
2. INTEGRATED SERVICEMODELS versus STANDARD CARE (non-critical outcomes)
2.1. Lost to treatment - by 36 months
2.2. Lost to evaluation - by 36 months
2.3. Mental state: 1. Relapse (hospitalisation days and crisis care) (skewed data)
2.4. Mental state: 2. Total symptoms (BPRS, high=poor)
2.6. Functioning: 2. Forensic measures (skewed data)
2.7. Functioning: 3. Outpatient medication service (mean number of hours) - 36 months
3. INTEGRATED ACT versus STANDARD CASEMANAGEMENT (critical outcomes)
3.2. Substance use: 1. Not in remission - by 36 months
3.3. Substance use: 2. Substance misuse (SATS, low=poor)
3.4. Service use: 1. Days in stable community residences (not in hospital)
4. INTEGRATED ACT versus STANDARD CASEMANAGEMENT (non-critical outcomes)
4.1. Lost to treatment - by 36 months
4.3. Mental state: 1. Relapse (hospitalisation days and crisis care) (skewed data)
4.4. Mental state: 2. Average score (BPRS, skewed data)
4.5. Service use: 2. Number hospitalised - during the 36 month study period
5. STAFFED ACCOMMODATION versus STANDARD CARE (critical outcomes)
5.1. Substance use: 1. Days used alcohol (low=poor)
5.2. Substance use: 2. Level of alcohol use (low=poor)
5.3. Substance use: 3. Days used drugs (low=poor)
5.4. Substance use: 4. Severity of drug use (low=poor)
Psychological/psychosocial interventions
1. CBT versus STANDARD CARE (critical outcomes)
1.1. Substance use: 1. Using substances - by 1 month
1.2. Substance use: 2. Using substances - by 3 months
1.3. Substance use: 3. Any substance (skewed data)
1.4. Substance use: 4. Drugs use - by 3 months (skewed data)
1.5. Substance use: 5. Drug use - by 6 months (skewed data)
1.6. Substance use: 6. Alcohol use - by 3 months (skewed data)
1.7. Substance use: 7. Alcohol use - by 6 months (skewed data)
2. CBT versus STANDARD CARE (non-critical outcomes)
2.2. Lost to treatment - sensitivity analysis (bipolar only)
2.4. Mental state: 1. Total score (BPRS, high = poor)
2.5. Mental state: 2. Postive symptoms (BPRS, high = poor) (skewed data)
2.6. Mental state: 3. Negative symptoms (SANS, high = poor) (skewed data)
2.7. Mental state: 4. Depressive symptoms (BDI-SF or HDRS, high = poor) (skewed data)
2.8. Mental state: 5. Depressive symptoms (Days reporting symptoms, high = poor) (skewed data)
2.9. Service use: 1. Outpatient attendance & medication (SURS, skewed data)
2.10. Adherence: 1. Not adherent with medication - by 3 months
3. MOTIVATIONAL INTERVIEWING versus STANDARD CARE (critical outcomes)
3.1. Substance use: 1. Not abstinent or not improved on all substances - by 12 months
3.2. Substance use: 2. Not abstaining from alcohol
3.3. Substance use: 3. Other measures of alcohol use (skewed data)
4. MOTIVATIONAL INTERVIEWING versus STANDARD CARE (non-critical outcomes)
5. CBT + MOTIVATIONAL INTERVIEWING versus STANDARD CARE (critical outcomes)
5.3. Substance use: 2. Average score - alcohol (skewed data)
5.4. Substance use: 3. Average score - amphetamine (skewed data)
5.5. Substance use: 4. Average score - cannabis (skewed data)
5.6. Substance use: 6. Average change in % days abstinent during & after treatment
5.7. Substance use: 7. TLFB:%days abstinent main substance (skewed data)
5.8. Substance use: 8. TLFB:%days abstinent all substance (skewed data)
5.9. Substance use: 9. Substance use per substance-using day
5.10. Functioning: 1. Average global functioning score (GAF, low = poor)
5.11. Functioning: 2. Average social functioning score (SFS, low = poor)
6. CBT + MOTIVATIONAL INTERVIEWING versus STANDARD CARE (non-critical outcomes)
6.4. Mental state: 2. Total score (PANSS, high = poor)
6.5. Mental state: 3. General symptoms (BPRS/PANSS, high = poor)
6.6. Mental state: 4. Positive symptoms (PANSS, high = poor)
6.7. Mental state: 5. Negative symptoms (PANSS/BPRS, high = poor)
6.8. Mental state: 6. Depressive symptoms (BDI-11, high = poor)
7. GROUP PSYCHOTHERAPY versus STANDARD CARE (critical outcomes)
7.1. Substance use: 1. Average score - C-DIS-R Drugs (skewed data)
7.2. Substance use: 2. Average score - C-DIS-R Alcohol (skewed data)
7.3. Functioning: 1. Average role functioning score (RFS, high = better functioning)
7.4. Functioning: 2. Average social adjustment score (SAS, high = better functioning)
8. GROUP PSYCHOTHERAPY versus STANDARD CARE (non-critical outcomes)
9. CONTINGENCYMANAGEMENT versus STANDARD CARE (critical outcomes)
9.1. Substance use: 1. Number of days/weeks of drug use (confirmation by urine drug screen)
9.2. Substance use: 2. Number of days/weeks of alcohol use (confirmation by breathalyser)
9.4. Substance use: 4. Alcohol positive breathalyser samples
- Psychosis with coexisting substance misuse: Evidence Update December 2012: A summary of selected new evidence relevant to NICE clinical guideline 120 'Psychosis with coexisting substance misuse: assessment and management in adults and young people' (2011)
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