Tone Helene Bergly

This study aimed to understand patients' experience of lapse in substance use in inpatient substance use disorder (SUD) treatment. By applying mixed methods design, the study could understand lapses and the influence detoxification treatment has on the potential severity of the lapse of using substances. Patients were recruited from an internal detoxification unit from an NGO in Norway. They answered a questionnaire (N = 46), with questions about background, lapses into substance use, craving to use substances, and psychological distress. Twelve patients were interviewed about lapses to substances and detoxification treatment. Lapses to substance use ranged from 1 to 10 days (M = 3.93), and the number of substances used ranged from one to seven (M = 2.48). During a lapse, seven (15.2%) patients had/unsure if they had one or more overdoses (ranging from one to five). Eight (17.4%) patients had lapses still unknown to the center. Some patients were scared by the power and danger of using substances. Almost 80% (n = 36) of the patients had high psychological distress, and some had high craving for substances. After a period of soberness, many perceived an increased struggle with mental health, and they tried to cope with it and decrease the pain by using substances. SUD treatment could reduce the severity of lapses to substance use. Quick access to detoxification and continuing treatment could be crucial, and a way to prevent dropout and overdoses.

Substance use disorder (SUD) can lead to cognitive impairment. The objective of our study is to investigate differences in cognitive impairment between psychostimulant users and opioid users after ...

Patients entering substance use disorder treatment perceive the quality of life as low and have high levels of psychological distress. Some suffer from impaired cognitive functioning. The prevalence of traumatic experiences is high. We aimed to determine whether there had been improvements from admission to discharge and explore the relationships between the improvements and experiences of traumatic abuse. We recruited 138 inpatients from long-term treatment for substance use disorders in Norway. 98 participants completed the questionnaires on quality of life, psychological distress, and cognitive functioning at admission and discharge. We found significant improvements in quality of life and cognitive functioning, and the psychological distress decreased from admission to discharge. Patients with experiences of traumatic abuse improved less in cognitive functioning. Measurements of quality of life, psychological distress, and cognitive functioning may be useful to assess improvements during treatment. Health providers must be aware of the high prevalence of mild cognitive impairment and psychological distress, and low quality of life in patients at admission to treatment. Patients with experiences of traumatic abuse improved less in cognitive functioning and treatment should target this, as it could hinder drop-out and enhance the success of substance use disorder treatment.

Background The Norwegian organization Golf as Therapy (GAT) offers golf training sessions for patients in mental health care and/or SUD treatment. Our aim for the article was to explore SUD patients' experiences of playing golf during their treatment. Method We conducted semistructured interviews with seven informants, all of whom were SUD patients or former SUD patients of the Tyrili Foundation. Results A thematic analysis led us to identify three themes. 1) The participants had negative stereotypical perceptions of golf and golf players. When they entered the golf course, these perceptions were largely refuted. 2) The participants enjoyed the versatility that golf demanded but highlighted the social interaction that occurred at the golf course as the most valuable and motivating part of their enjoyment of golf. 3) The participants had positive experiences playing golf that they saw as valuable for developing social networks and for becoming more open-minded about trying new activities. Conclusions Golf seems to potentially stimulate social participation and to develop relations, and it was perceived as useful for the informants' situations both during and after treatment. This may strengthening the patients' social identity and social capital. Therefore, golf as an activity could be benefiting for patients in SUD-treatment.

Objective: Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders and has some overlapping symptoms with mild cognitive impairment, including executive functions. We wanted to investigate whether patients with ADHD have an excess risk of mild cognitive impairment–like symptoms, as defined by the Montreal Cognitive Assessment (MoCA). Second, we assessed the impact of ADHD medication on the dichotomized MoCA for patients with ADHD. Methods: The participants in this study were 129 inpatients at seven treatment clinics in Norway. All were screened with the MoCA. We calculated relative risk estimates (RR) for scoring in the mild cognitive impairment range (< 26) for those having ADHD. Finally, we calculated the RR for the patients within the ADHD group who were taking medication. Results: Of the 129 participants included in the analyses, 38 (29.5%) scored below the MoCA threshold (< 26), and 24 (18.6%) had ADHD that was diagnosed before or during the inpatient treatment. Of the 105 participants without ADHD, 31 (29.5%) scored below the threshold. Seven (29.2%) of those with ADHD scored below the threshold. The risk of scoring in the mild cognitive impairment range for those with and without ADHD was equal (RR = 0.98). Of the 24 patients with ADHD, 9 (37.5%) were taking medication at the time of testing. One of the patients taking medication scored below the threshold compared to six of those not taking medication. This suggests a 72% lower risk of mild cognitive impairment–like symptoms when taking medication (RR = 0.28); however, the effect was not significant. Conclusions: We revealed no excess risk of mild cognitive impairment–like symptoms for the ADHD group. However, within the ADHD group, there was a possible lower risk of mild cognitive impairment–like symptoms for patients taking medication. These results suggest that there may be a confounding overlap of symptoms between ADHD and cognitive function screens that necessitates adequate assessment and treatment of ADHD before screening or measuring cognitive function.

Objectives: This study aimed to measure motivation for substance use treatment by using the University of Rhode Island Change Assessment (URICA). The composite URICA scores for Readiness To Change (RTC) and Committed Action (CA) were used to investigate their predictive validity regarding whether patients were still in substance use treatment 3 months after entering treatment. Methods: The sample consisted of 95 patients from substance use disorder treatment facilities in Norway. The patients were interviewed and given a self-administered URICA at pretreatment and 3 months later. Results and Conclusions: RTC and CA did not predict being in treatment 3 months later, and only minor associations were found with other investigated variables. The results indicate that the predictive validity of URICA for measuring motivation to change in substance use is low and URICA should be used with caution.

Objective: Persons with substance use disorders often have comorbid psychiatric problems, and treating all problem domains is important for treatment success and recovery. This study examined reported interventions provided to patients as well as patients’ reports of domains of help received, perceived areas of greatest benefit, and satisfaction with substance use disorder treatment. We also compared patients with co-occurring disorders and patients with only substance use disorders to see whether there were significant differences across groups on these measures. Methods: Patients receiving inpatient substance use treatment at clinics in Norway were recruited for the study; 85 completed a cross-sectional survey prior to discharge. Treatment personnel also completed a separate survey and gathered information from patient charts. Results: The most frequently provided treatment interventions involved improving relationships with family and important others, applied relaxation, psychodynamic therapy, cognitive behavior therapy, and motivational interviewing. Patients reported receiving the most help in domains of relapse prevention, physical health, daily functioning, relationships with people, psychological health, and self-esteem. They benefited most from physical activities, support from co-patients, group therapy, counseling, and assessment/treatment of psychological health. Patients with co-occurring disorders were given more exposure therapy, motivational interviewing, and cognitive behavior therapy interventions than those without comorbidity. Patients with co-occurring disorders self-reported receiving more help with self-esteem and coping with psychiatric symptoms and benefiting more from interventions involving psychological health, acute help, and social situations. Conclusions: Patients perceived psychological and physical health as important areas for improvement. There were differences between patients with co-occurring disorders and those with substance use disorders only in several measures. It is important to acknowledge that patients with substance use disorders and co-occurring mental problems are heterogeneous groups with unique but overlapping needs.

Objective: We examined and compared mental health and substance use problems among patients in substance use disorder treatment as reported by both patients and treatment personnel, and explored the feasibility of the quadrant model in addressing severity of mental health and substance use based on reports by treatment personnel. Methods: Patients receiving inpatient substance use treatment at clinics in Norway were recruited for the study; 85 completed a cross-sectional survey. Treatment personnel completed a separate survey and gathered information from patient charts. Results: While there were minor differences in the patient and personnel reported prevalence of mental disorders in general (34 and 41%, respectively), there were significant differences in reported affective disorders (p = 0.05) and personality disorders (p = 0.02). Based on the quadrant model, 70.2% of the patients had a high severity of substance use and low severity of mental health problems, while 21.4% had high severity of both. Conclusions: The differences in reports of mental disorders are important, and future research should aim to increase the validity and reliability of reported mental health problems among patients with substance use disorders. The quadrant model does seem to be a feasible model in addressing the severity of such co-occurring disorders.

Aim: To test the dimensional structure of the Symptom Check List-90-Revised (SCL-90-R) among inpatients with substance use disorders (SUD), and to examine whether the Global Severity Index (GSI) scores discriminated between SUD patients and a general Norwegian population sample. The concurrent validity of the SCL-90-R was also examined. Methods: The sample included 85 patients from inpatient SUD treatment clinics in Norway. The patients responded to a survey in the week before they were discharged from treatment. Results: The SCL-90-R is a feasible instrument for measuring general distress among patients with SUD. The patients reported higher scores on the GSI than the general population. This is coherent with the high prevalence of co-occurring psychiatric symptoms in the SUD population. The concurrent validity of SCL-90-R was satisfactory. Conclusion: The SCL-90-R is unidimensional, and the use of the earlier established factor structure is discussable. The GSI score may be a feasible alternative.