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Effectiveness of inpatient treatment programs for dually diagnosed patients

Research project DR/21 (Research action DR)


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The dually diagnosed patients as well as the people who work with them are tested in the study ‘Effectiveness of inpatient treatment programs for dually diagnosed patients’. The first part of the investigation focuses on the group of dually diagnosed patients. Dually diagnosed patients are patients with coexisting severe psychotic and substance use disorders. There are two questions that can be formulated:

1. Are dually diagnosed patients effectively treated when they follow a residential integrated treatment program?
2. Is there a difference in efficiency between the residential integrated treatment program and the residential non-integrated treatment program?

Psychiatric functioning, substance use, global functioning and life quality of the patients are being measured. The ‘Positive and Negative Syndrome Scale’ (PANSS) and the ‘Brief Psychiatric Rating Scale’ (BPRS) are used to determine psychiatric functioning. The ‘Addiction Severity Index’ (EuropASI), ‘Drug/alcohol 6-month Follow-back Calendar’ (TLFB), the ‘Alcohol Use Scale’ (AUS), the ‘Drugs Use Scale’ (DUS) and the ‘Readiness to Change Questionnaire’ (RCQ) measure the substance use. Global functioning is being measured by the ‘Global Assessment of Functioning’ (GAF) and the ‘Clinical Global Impressions’ (CGI). The ‘Schizophrenia Quality of Life Scale’ (SQLS) and the ‘Manchester Short Assessment of Quality of Life’ (MANSA) are used to evaluate the quality of life. We also try to formulate an answer on the question whether the patients who follow a residential integrated treatment program are more involved in treatment than patients who follow a residential non-integrated treatment program. Patients are being tested at intake, 3 months after intake, 6 months after intake and one year after intake.

The second part focuses on the people who work with the dually diagnosed patients. There is being investigated whether the job satisfaction is higher and the workstress is lower in people working in hospitals with integrated treatment programs. Every 6 months they fill in the ‘Symptom Check List’ (SCL-90), the ‘Leidse Arbeidskwaliteitsschaal’ (LAKS) and the ‘Nurse Stress Index’ (NSI).

The design is a non-equivalent comparison groups design. The results of non-equivalent, not randomised groups are being compared. In ‘Psyciatrisch centrum Sleidinge’ and in ‘Centre Hospitalier Psychiatric de Liège, Dédale’, a residential integrated treatment program was set up. The residential integrated treatment program can be seen as a combination of special assessment, outreaching work, motivational interviewing, individual and group counselling, a pharmacological treatment, psycho education, a long term perspective, different treatment stages and social network factors. The results of the dually diagnosed patients of the experimental institutions are being compared to the results of the dually diagnosed patients of ‘Psychiatrisch centrum Sint-Jan-Baptist’ at Zelzate and ‘Centre Hospitalier Psychiatrique de Liège’, department Cadran. The patients in these institutions receive a residential non-integrated treatment. The results of the employees are also being compared. In all institutions a process evaluation was conducted in previous research (1). We want to compare 40 dually diagnosed patients who followed an integrated treatment with 40 dually diagnosed patients who followed a non-integrated treatment.

(1) See “Haalbaarheidsonderzoek voor de evaluatie van behandelcentra voor patiënten met dubbeldiagnose” (De Wilde & Sabbe, 2003) and “Onderzoek naar de effectiviteit van behandelingsprogramma’s, specifiek voor patiënten met een dubbele diagnose” (De Wilde & Sabbe, 2004).


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