Demoralization in Patients With Substance Use and Co-Occuring Psychiatric Disorders

Gerdien H. De Weert, Wiebren Markus, David W Kissane, Cornelis A.J. De Jong

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: In recent years, treatment of substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance dependence and psychiatric disorders. Methods: 217 patients with co-occurring disorders and 179 community-based individuals participated in this study. Demoralization was measured twice over one month as inpatient treatment happened. Results: In contrast with the community sample, we found high levels of demoralization in the clinical cohort, with 86% of patients having demoralization scores above threshold. During the first month there was a statistically significant reduction in demoralization scores. However, clinically relevant change appeared limited, with only 3% of patients moving from dysfunctional to functional status in this naturalistic setting without targeted intervention aimed at remoralization. Conclusions: Although the level of demoralization is significantly improved during the first month of treatment, patients still remain strongly demoralized. Clinically relevant improvement is limited. It could be worthwhile to set up targeted interventions aimed at remoralization. Furthermore, we advocate for the assessment of demoralization in the clinical setting to monitor patients' treatment outcomes.
Original languageEnglish
Pages (from-to)136-143
Number of pages8
JournalJournal of Dual Diagnosis
Volume13
Issue number2
DOIs
Publication statusPublished - 18 Apr 2017

Keywords

  • Demoralization, patients with co-occurring disorders, recovery, remoralization, reliable change index

Cite this

De Weert, Gerdien H. ; Markus, Wiebren ; Kissane, David W ; De Jong, Cornelis A.J. / Demoralization in Patients With Substance Use and Co-Occuring Psychiatric Disorders. In: Journal of Dual Diagnosis. 2017 ; Vol. 13, No. 2. pp. 136-143.
@article{fb8c7551acef4b68bf776d2e13fd759d,
title = "Demoralization in Patients With Substance Use and Co-Occuring Psychiatric Disorders",
abstract = "Objective: In recent years, treatment of substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance dependence and psychiatric disorders. Methods: 217 patients with co-occurring disorders and 179 community-based individuals participated in this study. Demoralization was measured twice over one month as inpatient treatment happened. Results: In contrast with the community sample, we found high levels of demoralization in the clinical cohort, with 86{\%} of patients having demoralization scores above threshold. During the first month there was a statistically significant reduction in demoralization scores. However, clinically relevant change appeared limited, with only 3{\%} of patients moving from dysfunctional to functional status in this naturalistic setting without targeted intervention aimed at remoralization. Conclusions: Although the level of demoralization is significantly improved during the first month of treatment, patients still remain strongly demoralized. Clinically relevant improvement is limited. It could be worthwhile to set up targeted interventions aimed at remoralization. Furthermore, we advocate for the assessment of demoralization in the clinical setting to monitor patients' treatment outcomes.",
keywords = "Demoralization, patients with co-occurring disorders, recovery, remoralization, reliable change index",
author = "{De Weert}, {Gerdien H.} and Wiebren Markus and Kissane, {David W} and {De Jong}, {Cornelis A.J.}",
year = "2017",
month = "4",
day = "18",
doi = "10.1080/15504263.2017.1287457",
language = "English",
volume = "13",
pages = "136--143",
journal = "Journal of Dual Diagnosis",
issn = "1550-4263",
publisher = "Taylor & Francis",
number = "2",

}

Demoralization in Patients With Substance Use and Co-Occuring Psychiatric Disorders. / De Weert, Gerdien H.; Markus, Wiebren ; Kissane, David W; De Jong, Cornelis A.J.

In: Journal of Dual Diagnosis, Vol. 13, No. 2, 18.04.2017, p. 136-143.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Demoralization in Patients With Substance Use and Co-Occuring Psychiatric Disorders

AU - De Weert, Gerdien H.

AU - Markus, Wiebren

AU - Kissane, David W

AU - De Jong, Cornelis A.J.

PY - 2017/4/18

Y1 - 2017/4/18

N2 - Objective: In recent years, treatment of substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance dependence and psychiatric disorders. Methods: 217 patients with co-occurring disorders and 179 community-based individuals participated in this study. Demoralization was measured twice over one month as inpatient treatment happened. Results: In contrast with the community sample, we found high levels of demoralization in the clinical cohort, with 86% of patients having demoralization scores above threshold. During the first month there was a statistically significant reduction in demoralization scores. However, clinically relevant change appeared limited, with only 3% of patients moving from dysfunctional to functional status in this naturalistic setting without targeted intervention aimed at remoralization. Conclusions: Although the level of demoralization is significantly improved during the first month of treatment, patients still remain strongly demoralized. Clinically relevant improvement is limited. It could be worthwhile to set up targeted interventions aimed at remoralization. Furthermore, we advocate for the assessment of demoralization in the clinical setting to monitor patients' treatment outcomes.

AB - Objective: In recent years, treatment of substance use disorder has rekindled emphasis on recovery which, being a gradual process, starts with remoralization. In this study, we examine the level of demoralization throughout the treatment process for patients with comorbid substance dependence and psychiatric disorders. Methods: 217 patients with co-occurring disorders and 179 community-based individuals participated in this study. Demoralization was measured twice over one month as inpatient treatment happened. Results: In contrast with the community sample, we found high levels of demoralization in the clinical cohort, with 86% of patients having demoralization scores above threshold. During the first month there was a statistically significant reduction in demoralization scores. However, clinically relevant change appeared limited, with only 3% of patients moving from dysfunctional to functional status in this naturalistic setting without targeted intervention aimed at remoralization. Conclusions: Although the level of demoralization is significantly improved during the first month of treatment, patients still remain strongly demoralized. Clinically relevant improvement is limited. It could be worthwhile to set up targeted interventions aimed at remoralization. Furthermore, we advocate for the assessment of demoralization in the clinical setting to monitor patients' treatment outcomes.

KW - Demoralization, patients with co-occurring disorders, recovery, remoralization, reliable change index

U2 - 10.1080/15504263.2017.1287457

DO - 10.1080/15504263.2017.1287457

M3 - Article

VL - 13

SP - 136

EP - 143

JO - Journal of Dual Diagnosis

JF - Journal of Dual Diagnosis

SN - 1550-4263

IS - 2

ER -