Marianne Destoop1,2, Lise Docx1,2, Manuel Morrens1,3, Geert Dom1,2. 1. Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, 2610 Antwerp, Belgium. 2. Multiversum, Provinciesteenweg 408, 2530 Boechout, Belgium. 3. University Psychiatric Hospital Antwerp, Campus Duffel, 2570 Antwerp, Belgium.
Abstract
BACKGROUND: Substance use disorders (SUD) are highly prevalent among psychotic patients and are associated with poorer clinical and functional outcomes. Effective interventions for this clinical population are scarce and challenging. Contingency management (CM) is one of the most evidence-based treatments for SUD's, however, a meta-analysis of the effect of CM in patients with a dual diagnosis of psychotic disorder and SUD has not been performed. METHODS: We searched PubMed and PsycINFO databases up to December 2020. RESULTS: Five controlled trials involving 892 patients were included. CM is effective on abstinence rates, measured by the number of self-reported days of using after intervention (95% CI -0.98 to -0.06) and by the number of negative breath or urine samples after intervention (OR 2.13; 95% CI 0.97 to 4.69) and follow-up (OR 1.47; 95% CI 1.04 to 2.08). CONCLUSIONS: Our meta-analysis shows a potential effect of CM on abstinence for patients with SUD and (severe) psychotic disorders, although the number of studies is limited. Additional longitudinal studies are needed to confirm the sustained effectivity of CM and give support for a larger clinical implementation of CM within services targeting these vulnerable co-morbid patients.
BACKGROUND:Substance use disorders (SUD) are highly prevalent among psychoticpatients and are associated with poorer clinical and functional outcomes. Effective interventions for this clinical population are scarce and challenging. Contingency management (CM) is one of the most evidence-based treatments for SUD's, however, a meta-analysis of the effect of CM in patients with a dual diagnosis of psychotic disorder and SUD has not been performed. METHODS: We searched PubMed and PsycINFO databases up to December 2020. RESULTS: Five controlled trials involving 892 patients were included. CM is effective on abstinence rates, measured by the number of self-reported days of using after intervention (95% CI -0.98 to -0.06) and by the number of negative breath or urine samples after intervention (OR 2.13; 95% CI 0.97 to 4.69) and follow-up (OR 1.47; 95% CI 1.04 to 2.08). CONCLUSIONS: Our meta-analysis shows a potential effect of CM on abstinence for patients with SUD and (severe) psychotic disorders, although the number of studies is limited. Additional longitudinal studies are needed to confirm the sustained effectivity of CM and give support for a larger clinical implementation of CM within services targeting these vulnerable co-morbid patients.
Entities:
Keywords:
contingency management; psychosis; substance use disorder
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