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Schizophrenia Bulletin Advance Access originally published online on January 29, 2008
Schizophrenia Bulletin 2008 34(2):226-228; doi:10.1093/schbul/sbm165
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Psychosocial Treatment Programs for People With Both Severe Mental Illness and Substance Misuse

M. Cleary1,2,3, G. E. Hunt2,4, S. Matheson2, N. Siegfried5 and G. Walter6
2 Research Unit, Sydney South West Area Health Service (Eastern Zone), Rozelle Hospital, PO Box 1 Rozelle, NSW 2039, Australia
3 Faculty of Nursing and Midwifery
4 Discipline of Psychological Medicine, University of Sydney, New South Wales, Australia
5 South African Cochrane Centre, Medical Research Council, PO Box 19070, Tygerberg, 7505, South Africa
6 Discipline of Psychological Medicine, University of Sydney, Coral Tree Family Service, PO Box 142, North Ryde, NSW 1670, Australia

1 To whom correspondence should be addressed; tel: +61-2-9556-9493, fax: +61-2-9818-5712, e-mail: michelle.cleary{at}email.cs.nsw.gov.au.

Over 50% of people with a severe mental illness also use illicit drugs and/or alcohol at hazardous levels. This review is based on the findings of 25 randomized controlled trials which assessed the effectiveness of psychosocial interventions, offered either as one-off treatments or as an integrated or nonintegrated program, to reduce substance use by people with a severe mental illness. The findings showed that there was no consistent evidence to support any one psychosocial treatment over another. Differences across trials with regard to outcome measures, sample characteristics, type of mental illness and substance used, settings, levels of adherence to treatment guidelines, and standard care all made pooling results difficult. More quality trials are required that adhere to proper randomization methods; use clinically valuable, reliable, and validated measurement scales; and clearly report data, including retention in treatment, relapse, and abstinence rates. Future trials of this quality will allow a more thorough assessment of the efficacy of psychosocial interventions for reducing substance use in this challenging population.

Keywords: psychosocial interventions / cochrane review / dual diagnosis


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