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Article
Publication date: 31 December 2010

Roos Stals, Albert Dijkhuizen and Tom Joosten

GGzE, a mental health care organisation in the south Netherlands, implemented treatment for patients with severe personality disorders and substance use: clinical case management…

198

Abstract

GGzE, a mental health care organisation in the south Netherlands, implemented treatment for patients with severe personality disorders and substance use: clinical case management (CCM). CCM is a special healthcare facility for patients whose needs do not match other existing treatment designs. These patients are characterised by unproductive or disturbed relationships and multiple crises that deregulate clinical practice and impede recovery. In the CCM team, patients are treated with the theoretical concepts of relationship management, interpersonal reconstructive therapy, Livesley's stage‐wise treatment and integrated dual disorder treatment (IDDT). These theoretical models and methods used within CCM have been described extensively, though there has been no clinical study about its effect within GGzE so far. Professionals working within the CCM team report that behaviour such as acting out is reduced after about one year of treatment, with less interventions from other caretakers or police involvement. To substantiate these claims, a single group pre‐test and posttest was conducted to find out whether these patients really experience changes in physical and psychological problems, as well as changes in their personality disorder.The sample consists of patients who started treatment between 2004 and 2009 (pre measurement T=0), (n = 21). At T=0, patients completed the Symptom Checklist (SCL‐90) and Personality Characteristics Questionnaire (Vragenlijst Kenmerken Persoonlijkheid, VKP). The outcomes are compared with the results of the same questionnaires that were completed by patients in 2010 (post measurement T=1). The outcomes of the SCL‐90 show significant changes for fear, depression, hostility, distrust and interpersonal sensitivity, as well as the total score of psychoneurosis. The VKP shows significant changes for general personality disorder, schizoid personality disorder and borderline personality disorder. More research is needed to find stronger evidence of treatment effects of CCM, using a bigger sample, a control group and more outcome measurements that also include the drug use of patients.

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Advances in Dual Diagnosis, vol. 3 no. 4
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 14 December 2010

Liz Hughes

This short paper is a reflection on a visit to the Integrated Treatment Service for People with Personality Disorders in Eindhoven, in the Netherlands. The issues of cultural…

97

Abstract

This short paper is a reflection on a visit to the Integrated Treatment Service for People with Personality Disorders in Eindhoven, in the Netherlands. The issues of cultural attitudes and context in application of integrated treatment are discussed.

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Advances in Dual Diagnosis, vol. 3 no. 3
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 30 November 2012

Rebekah Brennan and Marie Claire Van Hout

Mephedrone is a synthetic stimulant drug causing entactogenic and hallucinogenic effects. A systematic review of all existing empirical research and literature from 2009‐2012 on…

255

Abstract

Purpose

Mephedrone is a synthetic stimulant drug causing entactogenic and hallucinogenic effects. A systematic review of all existing empirical research and literature from 2009‐2012 on this new psychoactive drug was conducted. This paper aims to report on that review.

Design/methodology/approach

The review was conducted according to PRISMA guidelines. Electronic databases were utilised using the search terms “mephedrone” and product nomenclature; “Plant Food”, “Feeder”, “Meow Meow”, “Miaow”, “Drone”, “Meph” “Bubbles”, “Charge”, and “MCat”. The search was restricted to publications from 2009‐2012, and produced 702 results. Data were collected by one member of the research team and cross checked by another. A primary screening was carried out to exclude inaccurate search results and drugs other than mephedrone. The results were studied and duplicates removed; 598 results were discarded, with 104 deemed suitable for inclusion.

Findings

The review underscores mephedrone's popularity despite legislative controls. Drug displacement patterns from illicit to licit were observed prior to controls, with blending of mephedrone and other substitute cathinones with street drugs thereafter. User consumptive choices are grounded in availability, perceptions of legality and safety, curiosity and perceived quality of drug outcomes within poly drug taking repertoires. Clinical reports indicate that mephedrone has high abuse potential and toxicity, with several dependence symptoms. Risk assessment, detection, diagnosis and treatment of mephedrone use are difficult due to polydrug use and associated mental health disorders.

Research limitations/implications

The review points to the need for further research into the pharmacology and toxicity of mephedrone in order to better equip clinicians with assessment, diagnosis and treatment strategies to reduce morbidity.

Practical implications

The increasingly diversified new psycho stimulant market where mephedrone is a major player poses unprecedented challenges for drug surveillance, policy, community and clinical practice.

Social implications

Stricter legislative controls including internet vendor responsibility for supply of mephedrone have been suggested, along with raising public awareness on an international level through coordinated efforts.

Originality/value

The last review was published in 2009 by the Psychonaut Webmapping Group. This review brings together a comprehensive new set of data sources as they relate to this drug.

Details

Drugs and Alcohol Today, vol. 12 no. 4
Type: Research Article
ISSN: 1745-9265

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