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Citation
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de Waal MM, Dekker JJM, Kikkert MJ, Christ C, Chmielewska J, Staats MWM, van den Brink W, Goudriaan AE. Addiction 2019; 114(4): 730-740. |
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Affiliation
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Arkin Mental Health Care, Department of Research, Klaprozenweg 111, 1033, NN, Amsterdam, the Netherlands. |
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Abstract
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BACKGROUND AND AIMS: Patients with co-occurring substance use and other mental disorders are vulnerable to crime victimization, yet no evidence based preventive interventions exist. Our aim was to test the efficacy of a new intervention, Self-wise, Other-wise, Streetwise training (SOS-training), to prevent victimization in these dual diagnosis patients as an add-on to care as usual.
DESIGN: Multi-site single-blind parallel randomized controlled trial. SETTING: Three sites within one psychiatric service in Amsterdam, the Netherlands. PARTICIPANTS: Adult inpatients and outpatients with dual diagnosis (n=250), who were predominantly male (70.4%), on average 42.1 years old, and diagnosed with 3.7 DSM-IV disorders. INTERVENTION AND COMPARATOR: Care as usual, consisting of pharmacotherapy combined with individual psychotherapy, group psychotherapy and/or supportive counselling (n=125) was compared with care as usual plus SOS-training: a 6-week, 12-session manualized group training focused on enhancing emotion regulation skills, conflict resolution skills, and street skills (n=125). MEASUREMENTS: Victimization was assessed with the Safety Monitor, the Dutch equivalent of the International Crime Victims Survey, in a face-to-face assessment. The primary outcome measure was treatment response (yes/no), with yes defined as reporting at least a 50% reduction in the number of past year victimization incidents at the 14-month follow-up compared with baseline. Analyses were performed according to the intention-to-treat principle.
FINDINGS: The proportion of participants achieving treatment response for total victimization was 54.0% in the control group and 67.6% in the experimental group, a significant difference [odds ratio (OR)= 1.78, 95% confidence interval (CI)= 1.02-3.11, P=.042]. Treatment response for violent victimization was achieved by 68.7% of the control group and 79.3% of the experimental group (OR= 1.75, 95% CI= 0.91-3.34, P=.092). With a Bayes factor of 2.26, this result was inconclusive.
CONCLUSIONS: Among dual diagnosis patients, care as usual plus Self-wise, Other-wise, Streetwise (SOS) training was more effective in preventing victimization than care as usual alone.
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Language: en |