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Cited by 67Substance Abuse Treatment and OutcomesPsychiatric care and mental health servicesMental Health Treatment and Access

Effectiveness of Integrated Dual Diagnosis Treatment (IDDT) in Severe Mental Illness Outpatients with a Co-Occurring Substance Use Disorder

Open access
Kikkert, Martijn, Goudriaan, Anneke, de Waal, Marleen, Peen, Jaap, Dekker, Jack·2018·Journal of Substance Abuse Treatment
DOI 10.1016/j.jsat.2018.09.005
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Abstract

Integrating substance use disorder treatment with psychiatric treatment is considered more favourable then treating these disorders parallel or sequential, but the evidence base is inconclusive. We examined the effectiveness of Integrated Dual Diagnosis Treatment (IDDT) on substance use in severe mental illness outpatients with substance use disorders. IDDT is a collaborative, multidisciplinary team approach in which motivational interviewing is a key element. In addition, we also examined the effects of IDDT implementation on skills and knowledge of mental health care professionals. A randomized controlled stepped-wedge cluster trial was performed in 6 functional assertive cummunity treatment teams. We included 37 clinicians who were given a three-day IDDT training. Our primary outcome was days of substance use at follow up, 12 months after IDDT implementation. This was assessed in 154 included patients and was measured with the Measurement in the Addiction for Triage and Evaluation. After implementation of IDDT we found a reduction in the number of days patients used alcohol or drugs, but no improvements on other secondary outcomes such as psychopathology, functioning, therapeutic alliance or motivation to change. Also, IDDT training did not seem to improve clinicians' knowledge, attitudes and motivational interviewing skills. Effects on our secondary outcomes may have been limited by the absence of a training effect in our clinicians. Our study clearly underlines the complexity of disseminating IDDT and in particular motivational interviewing.

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  • Individuals receiving integrated care experience enhanced treatment engagement, reduced substance use, improved mental health, and an overall better quality of life.

    “individuals receiving integrated care experience enhanced treatment engagement, reduced substance use, improved mental health, and an overall better quality of life [20,21].”

    From Navigating the Complex Intersection of Substance Use and Psychiatric Disorders: A Comprehensive Review (2024) · cites this paper as [21]

    The Results report fewer days of substance use after IDDT, supporting that part of the claim. They do not show improved engagement, mental health, or overall quality of life: therapeutic alliance and self-rated mental health decreased in the experimental condition, and motivation to change did not improve. The reported improvement in appreciation of physical health does not establish better overall quality of life. (LLM, conf=0.90)

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2 of the 60 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Lukoff, D., Nuechterlein, K., & Ventura, J. (1986). Manual for expanded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin, 12, 594-602.

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Authors
Kikkert, M., Goudriaan, A., de Waal, M., Peen, J., & Dekker, J.
Affiliations
Arkin (NL)
Corresponding author
Kikkert, Martijn
ORCID
Venue
Journal of Substance Abuse Treatment
Publisher
Elsevier BV
Published
2018-12
Volume
95
Pages
35-42
ISSN
0740-5472 (ISSN-L)
DOI
10.1016/j.jsat.2018.09.005
OpenAlex
W2893515948
Cited by
67
References
60
Citations by year
2026: 14 · 2025: 10 · 2024: 9 · 2023: 7 · 2022: 12 · 2021: 8 · 2020: 3 · 2019: 4
FWCI
2.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Substance Abuse Treatment (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Funders
MIND Netherlands (20116628)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
severe mental illness, co-occurring substance use disorders, motivational interviewing, clinician training, multidisciplinary team, treatment effectiveness, treatment dissemination
MeSH terms
Therapeutic Alliance, Adult, Mental Disorders, Clinical Competence, Female, Follow-Up Studies, Health Personnel, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Motivation, Outpatients, Patient Care Team, Severity of Illness Index, Diagnosis, Dual (Psychiatry), Substance-Related Disorders, Motivational Interviewing

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