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Meta-Analysis
. 2019 Dec 12;12(12):CD001088.
doi: 10.1002/14651858.CD001088.pub4.

Psychosocial interventions for people with both severe mental illness and substance misuse

Glenn E Hunt  1 , Nandi Siegfried  2 , Kirsten Morley  3 , Carrie Brooke-Sumner  2 , Michelle Cleary  4
Affiliations
Meta-Analysis

Psychosocial interventions for people with both severe mental illness and substance misuse

Glenn E Hunt et al. Cochrane Database Syst Rev. .

Abstract

Background: Even low levels of substance misuse by people with a severe mental illness can have detrimental effects.

Objectives: To assess the effects of psychosocial interventions for reduction in substance use in people with a serious mental illness compared with standard care.

Search methods: The Information Specialist of the Cochrane Schizophrenia Group (CSG) searched the CSG Trials Register (2 May 2018), which is based on regular searches of major medical and scientific databases.

Selection criteria: We included all randomised controlled trials (RCTs) comparing psychosocial interventions for substance misuse with standard care in people with serious mental illness.

Data collection and analysis: Review authors independently selected studies, extracted data and appraised study quality. For binary outcomes, we calculated standard estimates of risk ratio (RR) and their 95% confidence intervals (CIs) on an intention-to-treat basis. For continuous outcomes, we calculated the mean difference (MD) between groups. Where meta-analyses were possible, we pooled data using a random-effects model. Using the GRADE approach, we identified seven patient-centred outcomes and assessed the quality of evidence for these within each comparison.

Main results: Our review now includes 41 trials with a total of 4024 participants. We have identified nine comparisons within the included trials and present a summary of our main findings for seven of these below. We were unable to summarise many findings due to skewed data or because trials did not measure the outcome of interest. In general, evidence was rated as low- or very-low quality due to high or unclear risks of bias because of poor trial methods, or inadequately reported methods, and imprecision due to small sample sizes, low event rates and wide confidence intervals. 1. Integrated models of care versus standard care (36 months) No clear differences were found between treatment groups for loss to treatment (RR 1.09, 95% CI 0.82 to 1.45; participants = 603; studies = 3; low-quality evidence), death (RR 1.18, 95% CI 0.39 to 3.57; participants = 421; studies = 2; low-quality evidence), alcohol use (RR 1.15, 95% CI 0.84 to 1.56; participants = 143; studies = 1; low-quality evidence), substance use (drug) (RR 0.89, 95% CI 0.63 to 1.25; participants = 85; studies = 1; low-quality evidence), global assessment of functioning (GAF) scores (MD 0.40, 95% CI -2.47 to 3.27; participants = 170; studies = 1; low-quality evidence), or general life satisfaction (QOLI) scores (MD 0.10, 95% CI -0.18 to 0.38; participants = 373; studies = 2; moderate-quality evidence). 2. Non-integrated models of care versus standard care There was no clear difference between treatment groups for numbers lost to treatment at 12 months (RR 1.21, 95% CI 0.73 to 1.99; participants = 134; studies = 3; very low-quality evidence). 3. Cognitive behavioural therapy (CBT) versus standard care There was no clear difference between treatment groups for numbers lost to treatment at three months (RR 1.12, 95% CI 0.44 to 2.86; participants = 152; studies = 2; low-quality evidence), cannabis use at six months (RR 1.30, 95% CI 0.79 to 2.15; participants = 47; studies = 1; very low-quality evidence) or mental state insight (IS) scores by three months (MD 0.52, 95% CI -0.78 to 1.82; participants = 105; studies = 1; low-quality evidence). 4. Contingency management versus standard care We found no clear differences between treatment groups for numbers lost to treatment at three months (RR 1.55, 95% CI 1.13 to 2.11; participants = 255; studies = 2; moderate-quality evidence), number of stimulant positive urine tests at six months (RR 0.83, 95% CI 0.65 to 1.06; participants = 176; studies = 1) or hospitalisations (RR 0.21, 95% CI 0.05 to 0.93; participants = 176; studies = 1); both low-quality evidence. 5. Motivational interviewing (MI) versus standard care We found no clear differences between treatment groups for numbers lost to treatment at six months (RR 1.71, 95% CI 0.63 to 4.64; participants = 62; studies = 1). A clear difference, favouring MI, was observed for abstaining from alcohol (RR 0.36, 95% CI 0.17 to 0.75; participants = 28; studies = 1) but not other substances (MD -0.07, 95% CI -0.56 to 0.42; participants = 89; studies = 1), and no differences were observed in mental state general severity (SCL-90-R) scores (MD -0.19, 95% CI -0.59 to 0.21; participants = 30; studies = 1). All very low-quality evidence. 6. Skills training versus standard care At 12 months, there were no clear differences between treatment groups for numbers lost to treatment (RR 1.42, 95% CI 0.20 to 10.10; participants = 122; studies = 3) or death (RR 0.15, 95% CI 0.02 to 1.42; participants = 121; studies = 1). Very low-quality, and low-quality evidence, respectively. 7. CBT + MI versus standard care At 12 months, there was no clear difference between treatment groups for numbers lost to treatment (RR 0.99, 95% CI 0.62 to 1.59; participants = 327; studies = 1; low-quality evidence), number of deaths (RR 0.60, 95% CI 0.20 to 1.76; participants = 603; studies = 4; low-quality evidence), relapse (RR 0.50, 95% CI 0.24 to 1.04; participants = 36; studies = 1; very low-quality evidence), or GAF scores (MD 1.24, 95% CI -1.86 to 4.34; participants = 445; studies = 4; very low-quality evidence). There was also no clear difference in reduction of drug use by six months (MD 0.19, 95% CI -0.22 to 0.60; participants = 119; studies = 1; low-quality evidence).

Authors' conclusions: We included 41 RCTs but were unable to use much data for analyses. There is currently no high-quality evidence to support any one psychosocial treatment over standard care for important outcomes such as remaining in treatment, reduction in substance use or improving mental or global state in people with serious mental illnesses and substance misuse. Furthermore, methodological difficulties exist which hinder pooling and interpreting results. Further high-quality trials are required which address these concerns and improve the evidence in this important area.

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Conflict of interest statement

None. The authors are employed as follows.

Glenn E Hunt, BA, MSc, PhD Principal Research Fellow/Associate Professor, Discipline of Psychiatry and Addiction Medicine, University of Sydney and Research Unit, Concord Centre for Mental Health, Sydney Local Health District, Hospital Road, Concord, NSW, 2139, Australia.

Nandi Siegfried, MBChB, MPH (Hons), DPhil (Oxon), FCPHM Honorary Associate Professor, Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa, and Chief Specialist Scientist, Alcohol, tobacco and other Drug Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, South Africa.

Kirsten Morley, BPsych (Hons), PhD NSW Health EMC Fellow/Associate Professor, NHMRC Center of Research Excellence in mental health and substance use, Addiction Medicine, University of Sydney, Camperdown, NSW, 2006, Australia

Carrie Brooke‐Sumner, BSc(Hons), MSc, PhD Post‐Doctoral Fellow, Alcohol, tobacco and other Drug Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, South Africa.

Michelle Cleary, RN, BHlthSc (Nurs), MHlth Sc (Nurs), PhD Professor, School of Nursing, College of Health and Medicine, University of Tasmania, Lilyfield, NSW, 2040, Australia.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
3
3
Study flow diagram for 2018 search
1.1
1.1. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 1 Leaving the study early: 1. Lost to treatment ‐ by 36 months.
1.2
1.2. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 2 Leaving the study early: 2. Lost to evaluation.
1.3
1.3. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 3 Adverse event: 1. Death ‐ by 36 months.
1.4
1.4. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 4 Substance use: 1. Clinically important change (not in remission) ‐ by 36 months.
1.5
1.5. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 5 Substance use: 2. Average score for progress towards recovery (SATS, low = poor).
1.13
1.13. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 13 Global state: 1. Average score (GAF, low = poor).
1.15
1.15. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 15 Quality of life/ life satisfaction: 1. Average general score (QOLI, range 1‐7, low = poor).
1.16
1.16. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 16 Service use: 1. Days in stable community residences (not in hospital).
1.17
1.17. Analysis
Comparison 1 Integrated models of care versus standard care, Outcome 17 Service use: 2. Number hospitalised ‐ during the 36 month study period.
2.1
2.1. Analysis
Comparison 2 Non‐integrated models of care (Assertive Community Treatment / Intensive Case Management / Specialised case management sercives) versus standard care, Outcome 1 Leaving the study early: 1. Lost to treatment.
2.2
2.2. Analysis
Comparison 2 Non‐integrated models of care (Assertive Community Treatment / Intensive Case Management / Specialised case management sercives) versus standard care, Outcome 2 Leaving the study early: 2. Lost to evaluation.
2.9
2.9. Analysis
Comparison 2 Non‐integrated models of care (Assertive Community Treatment / Intensive Case Management / Specialised case management sercives) versus standard care, Outcome 9 Social functioning: 1. Average role functioning score (RFS, high = better functioning).
2.10
2.10. Analysis
Comparison 2 Non‐integrated models of care (Assertive Community Treatment / Intensive Case Management / Specialised case management sercives) versus standard care, Outcome 10 Social functioning: 2. Average social adjustment score (SAS, high = better functioning).
3.1
3.1. Analysis
Comparison 3 Cognitive behavioural therapy versus standard care, Outcome 1 Leaving the study early: 1. Lost to treatment.
3.2
3.2. Analysis
Comparison 3 Cognitive behavioural therapy versus standard care, Outcome 2 Leaving the study early: 2. Lost to evaluation.
3.3
3.3. Analysis
Comparison 3 Cognitive behavioural therapy versus standard care, Outcome 3 Substance use: 1. Percentage of participants who used cannabis ‐ in last 4 weeks.
3.5
3.5. Analysis
Comparison 3 Cognitive behavioural therapy versus standard care, Outcome 5 Mental state: 1. Average insight score (Insight Scale, low = poor) ‐ by 3 months.
3.7
3.7. Analysis
Comparison 3 Cognitive behavioural therapy versus standard care, Outcome 7 Social functioning: 1. Average score (SOFAS, low = poor).
4.1
4.1. Analysis
Comparison 4 Contingency management versus standard care, Outcome 1 Leaving the study early: 1. Lost to treatment.
4.2
4.2. Analysis
Comparison 4 Contingency management versus standard care, Outcome 2 Leaving the study early: 2. Lost to evaluation ‐ 6 months.
4.3
4.3. Analysis
Comparison 4 Contingency management versus standard care, Outcome 3 Substance use: 1. Stimulant‐positive urine test (higher = poor outcome).
4.5
4.5. Analysis
Comparison 4 Contingency management versus standard care, Outcome 5 Substance use: 3. Injection use.
4.8
4.8. Analysis
Comparison 4 Contingency management versus standard care, Outcome 8 Service use: 1. Relapse (hospitalised ‐ 6 months post‐randomisation.
5.1
5.1. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 1 Leaving the study early: 1. Lost to treatment.
5.2
5.2. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 2 Leaving the study early: 2.Lost to evaluation.
5.3
5.3. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 3 Adverse event: 1. Death, due to all causes, by 18 months.
5.4
5.4. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 4 Substance use: 1. Using substances ‐ by class of drug ‐ by about 12 months.
5.5
5.5. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 5 Substance use: 2. Polydrug consumption levels ‐ by 12 months (OTI, high = poor).
5.6
5.6. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 6 Substance use: 3. Any change ‐ not abstinent or not improved on all substances ‐ by 12 months.
5.7
5.7. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 7 Substance use: 4. Any change ‐ not abstaining from alcohol.
5.8
5.8. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 8 Substance use: 5. Change in cannabis use from baseline (T0) (lower scores indicate better outcome).
5.10
5.10. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 10 Substance use: 7. Engagement with substance misuse treatment at 3 months (SATS, low = poor)).
5.13
5.13. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 13 Mental state: 1. Average scores (SCL‐90‐R, high = poor) ‐ by 3 months.
5.14
5.14. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 14 Mental state: 2. Average scores (PANSS negative symptoms, high = poor).
5.15
5.15. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 15 Mental state: 3. Average scores (PANSS positive symptoms, high = poor).
5.17
5.17. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 17 Global state: 1. Average score (GAF, low = poor).
5.19
5.19. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 19 Social functioning: 1. Average score (OTI, high = poor).
5.20
5.20. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 20 Social functioning: 2. Average score (SOFAS, low = poor).
5.21
5.21. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 21 Service use: Hospital admission to 12 months.
5.22
5.22. Analysis
Comparison 5 Motivational interviewing versus standard care, Outcome 22 Service use: Lost to first aftercare appointment.
6.1
6.1. Analysis
Comparison 6 Skills training versus standard care, Outcome 1 Leaving the study early: 1. Lost to treatment.
6.2
6.2. Analysis
Comparison 6 Skills training versus standard care, Outcome 2 Leaving the study early: 2. Lost to evaluation.
6.3
6.3. Analysis
Comparison 6 Skills training versus standard care, Outcome 3 Adverse event: 1. Death ‐ by 12 months.
6.4
6.4. Analysis
Comparison 6 Skills training versus standard care, Outcome 4 Substance use: 1. Alcohol use: proportion days abstinent from alcohol (TLFB method).
6.7
6.7. Analysis
Comparison 6 Skills training versus standard care, Outcome 7 Social functioning: 1. Average score (RFS, high = better functioning).
6.8
6.8. Analysis
Comparison 6 Skills training versus standard care, Outcome 8 Social functioning: 2. Average score (SAS, high = better functioning).
7.1
7.1. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 1 Leaving the study early 1. Lost to treatment.
7.2
7.2. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 2 Leaving the study early: 2. Lost to evaluation.
7.3
7.3. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 3 Adverse event: 1. Death ‐ by about 1 year.
7.4
7.4. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 4 Adverse event: 2. Death or hospitalisation by 24 months.
7.5
7.5. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 5 Substance use: 1. Average number of different drugs used during the past month (OTI, high = poor).
7.6
7.6. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 6 Substance use: 2. Cannabis use last 30 days.
7.7
7.7. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 7 Substance use 3. Clinically important change ‐change in main substance use, abstinent or large decease.
7.10
7.10. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 10 Mental state: 1. Average score (PANSS, total, high = poor).
7.11
7.11. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 11 Mental state: 2. Average score (PANSS positive symptoms, high = poor).
7.12
7.12. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 12 Mental state: 3. Average score (PANSS negative symptoms, high = poor).
7.14
7.14. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 14 Global state: 1. Average score (GAF, low = poor).
7.15
7.15. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 15 Global state: 2. Forensic measures ‐ arrests reported ‐ by 6 months.
7.16
7.16. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 16 Social functioning: 1. Average score (SFS, low = poor).
7.17
7.17. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 17 Quality of life/ life satisfaction: 1. Average score (BQOL (general life satisfaction, low = poor) ‐ by 6 months.
7.18
7.18. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 18 Quality of life/ life satisfaction: 2. Average score (BQOL (overall quality of life, low = poor) ‐ by 6 months.
7.19
7.19. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 19 Quality of life/ life satisfaction: 3. Average score (WHOQOL, Bref, higher scores = better QoL) ‐ by 6 months.
7.20
7.20. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 20 Quality of life/ life satisfaction: 4. Average score (MANSA, higher scores = better QoL).
7.21
7.21. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 21 Quality of life/ life satisfaction: 5. Average score (CSQ ‐ client satisfaction, high = good) ‐ by 10 months.
7.22
7.22. Analysis
Comparison 7 Cognitive behavioural therapy + motivational interviewing versus standard care, Outcome 22 Service use: 1. Relapse (hospitalised).
10.1
10.1. Analysis
Comparison 10 Sensitivity analysis, Outcome 1 Motivational interviewing versus standard care: Leaving the study early: 1. Lost to evaluation short term (3‐6 months): Diagnostic criteria.
10.2
10.2. Analysis
Comparison 10 Sensitivity analysis, Outcome 2 Cognitive behavioural therapy + motivational interviewing versus standard care: Global state: 1. Average score (GAF, low = poor) at 12 months: Allocation concealment.
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Update of

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    1. Eack SM, Hogarty SS, Greenwald DP, Litschge MY, McKnight SA, Bangalore SS, et al. Cognitive Enhancement Therapy in substance misusing schizophrenia: results of an 18‐month feasibility trial. Schizophrenia Bulletin 2015;41:S310. [CSzG: 29436] - PMC - PubMed
    1. Wojtalik JA, Eack SM. Fronto‐limbic neuroplasticity effects of Cognitive Enhancement Therapy during emotion regulation in schizophrenia patients who abuse cannabis. Schizophrenia Bulletin 2015;41:S243. [CSzG: 29719]
    1. Wojtalik JA, Hogarty SS, Cornelius JR, Phillips ML, Keshavan MS, Newhill CE, et al. Cognitive Enhancement Therapy improves frontolimbic regulation of emotion in alcohol and/or cannabis misusing schizophrenia: a preliminary study. Frontiers in Psychiatry 2016;6:186. [CSzG: 33452] - PMC - PubMed
Edwards 2006 {published data only}
    1. Edwards J, Elkins K, Hinton M, Harrigan SM, Donovan K, Athanasopoulos O, et al. Randomized controlled trial of a cannabis‐focused intervention for young people with first‐episode psychosis. Acta Psychiatrica Scandinavica 2006;114(2):109‐17. [CSzG: 13211] - PubMed
Essock 2006 {published data only}
    1. Essock SM, Mueser KT, Drake RE, Covell NH, McHugo GJ, Frisman LK, et al. Comparison of ACT and and standard case management for delivering integrated treatment for co‐occurring disorders. Psychiatric Services 2006;57(2):185‐96. [CSzG: 12680] - PubMed
    1. Kanter J. Clinical case management, case management and ACT. Psychiatric Services 2006; Vol. 57, issue 4:578. - PubMed
    1. Manuel JI. A longitudinal analysis of psychiatric medication adherence and provider continuity among individuals with co‐occurring disorders. Dissertation Abstracts International Section A: Humanities and Social Sciences 2009;69(10A):4126.
    1. Manuel JI, Covell NH, Jackson CT, Essock SM. Does assertive community treatment increase medication adherence for people with co‐occurring psychotic and substance use disorders?. Journal of the American Psychiatric Nurses Association 2011;17(1):51‐6. [CSzG: 22855] - PMC - PubMed
Godley 1994 {published data only}
    1. Godley SH, Hoewing‐Roberson R, Godley MD. Final MISA Report. Bloomington, IN: Lighthouse Institute, 1994. [CSzG: 970]
Gouzoulis‐Mayfrank 2015 {published and unpublished data}
    1. Gouzoulis‐Mayfrank E, Konig S, Koebke S, Schness T, Schmitz‐Buhl M, Daumann J. Trans‐sector integrated treatment in psychosis and addiction. Deutsches Arzteblatt International 2015;112(41):683‐91. [CSzG: 33168] - PMC - PubMed
    1. U1111‐1119‐5851. Evaluation of an integrative therapy approach for the comorbidity of psychosis and addiction. http://www.drks.de/DRKS00000671 2011. [CSzG: 22748]
Graeber 2003 {published data only}
    1. Graeber DA, Moyers TB, Griffith G, Guajardo E, Tonigan S. A pilot study comparing motivational interviewing and an educational intervention in patients with schizophrenia and alcohol use disorders. Community Mental Health Journal 2003;39(3):189‐202. [CSzG: 9901] - PubMed
Graham 2016 {published and unpublished data}
    1. Graham HL, Birchwood M, Griffith E, Freemantle N, McCrone P, Stefanidou CA, et al. A pilot study to assess the feasibility and impact of a brief motivational intervention on problem drug and alcohol use in adult mental health inpatient units: study protocol for a randomized controlled trial. Trials 2014;15(1):308. [CSzG: 29050] - PMC - PubMed
    1. Graham HL, Copello A, Griffith E, Freemantle N, McCrone P, Clarke L, et al. Pilot randomised trial of a brief intervention for comorbid substance misuse in psychiatric in‐patient settings. Acta Psychiatrica Scandinavica 2016;133(4):298‐309. [CSzG: 33324] - PMC - PubMed
    1. ISRCTN43548483. A pilot study to assess the feasibility and impact of a motivational intervention (MI) on problem drug and alcohol use in adult mental health inpatient units. http://isrctn.org/ISRCTN43548483 2014. [CSzG: 28909] - PMC - PubMed
Hellerstein 1995 {published data only}
    1. Hellerstein DJ, Rosenthal RN, Miner CR. A prospective study of integrated outpatient treatment for substance‐abusing schizophrenic patients. American Journal on Addictions 1995;4(1):33‐42. [CSzG: 5029]
    1. Hellerstein DJ, Rosenthal RN, Miner CR. Integrating services for schizophrenia and substance abuse. Psychiatric Quarterly 2001;72(4):291‐306. [CSzG: 8206] - PubMed
Hickman 1997 {unpublished data only}
    1. Hickman ME. The effects of personal feedback on alcohol intake in dually diagnosed clients: an empirical study of William R. Miller's motivational enhancement therapy. Unpublished thesis. University Graduate School, Dept. Counseling Psychology, Indiana University 1997. [CSzG: 4153]
Hjorthoj 2013 {published and unpublished data}
    1. Fohlmann AH, Hjorthoej C, Larsen A, Nordentoft M. CapOpus. randomized clinical trial: Specialized addiction treatment (MI & CBT) versus treatment as usual for young patients with cannabis abuse and psychosis. Early Intervention in Psychiatry 2010;4 Suppl 1:159. [CSzG: 23478]
    1. Fohlmann AH, Hjorthoej C, Larsen A, Nordentoft M. CapOpus. randomized clinical trial: Specialized addiction treatment (MI & CBT) versus treatment as usual for young patients with cannabis abuse and psychosis. Early Intervention in Psychiatry 2010;4 Suppl 1:160. [CSzG: 23478]
    1. Hjorthaj CR. Validity of self‐reported cannabis use as measured by the timeline follow‐back instrument in a trial randomizing people with comorbid cannabis use disorder and schizophrenia spectrum disorder. Early Intervention in Psychiatry 2010;4 Suppl 1:160. [CSzG: 23483]
    1. Hjorthoj C, Fohlmann A, Larsen AM, Madsen MT, Vesterager L, Gluud C, et al. Design paper: the CapOpus trial: a randomized, parallel‐group, observer‐blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis. Trials 2008;9:42. [CSzG: 16594] - PMC - PubMed
    1. Hjorthoj CR, Fohlmann A, Larsen A‐M, Madsen MTR, Vesterager L, Gluud C, et al. Interim analysis of the CapOpus trial: a randomized, parallel‐group, observer‐blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis. Schizophrenia Research 2010;117(2‐3):190. [CSzG: 20563]
Jerrell 1995a {unpublished data only}
    1. Jerrell JM. Cost‐effective treatment for persons with dual disorders. New Directions for Mental Health Services 1996;70(Summer):79‐91. [CSzG: 16821] - PubMed
    1. Jerrell JM, Hu TW, Ridgely MS. Cost‐effectiveness of substance disorder interventions for people with severe mental illness. Journal of Mental Health Administration 1994;21(3):283‐97. [CSzG: 1166] - PubMed
    1. Jerrell JM, Ridgely MS. Comparative effectiveness of three approaches to serving people with severe mental illness and substance abuse disorders. Journal of Nervous and Mental Disease 1995;183(9):566‐76. [CSzG: 3727] - PubMed
    1. Jerrell JM, Ridgely MS. Impact of robustness of program implementation on outcomes of clients in dual diagnosis programs. Psychiatric Services 1999;50(1):109‐12. [CSzG: 16917] - PubMed
Jerrell 1995b {unpublished data only}
    1. Jerrell JM, Ridgely MS. Comparative effectiveness of three approaches to serving people with severe mental illness and substance abuse disorders. Journal of Nervous and Mental Disease 1995;183(9):566‐76. [CSzG: 3727] - PubMed
Kavanagh 2004 {published data only}
    1. Kavanagh DJ, Young R, White A, Saunders JB, Wallis J, Shockley N, et al. A brief motivational intervention for substance misuse in recent‐onset psychosis. Drug and Alcohol Review 2004;23(2):151‐5. [CSzG: 8309] - PubMed
Kemp 2007 {published and unpublished data}
    1. Kemp R, Harris A, Vurel E, Sitharthan T. Stop using stuff: trial of a drug and alcohol intervention for young people with comorbid mental illness and drug and alcohol problems. Australasian Psychiatry 2007;15(6):490‐3. [CSzG: 15549; MEDLINE: ] - PubMed
Lehman 1993 {published data only}
    1. Lehman AF, Herron JD, Schwartz RP, Myers CP. Rehabilitation for adults with severe mental illness and substance use disorders: a clinical trial. Journal of Nervous and Mental Disease 1993;181(2):86‐90. [CSzG: 1646] - PubMed
Madigan 2013 {published data only}
    1. Madigan K, Brennan D, Lawlor E, Turner N, Kinsella A, O'Connor JJ, et al. A multi‐center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness. Schizophrenia Research 2013;143(1):138‐42. [CSzG: 25073] - PubMed
Maloney 2006 {unpublished data only}
    1. Maloney MP. Reducing criminal recidivism in jail‐incarcerated mothers with co‐occurring disorders. Manuscript kindly provided by Dr Maloney ‐ no further details given.
McDonell 2013 {published and unpublished data}
    1. Angelo FN, McDonell MG, Lewin MR, Srebnik D, Lowe J, Roll J, et al. Predictors of stimulant abuse treatment outcomes in severely mentally ill outpatients. Drug and Alcohol Dependence 2013;131(1‐2):162‐5. - PMC - PubMed
    1. McDonell MG, Srebnik D, Angelo F, McPherson S, Lowe JM, Sugar A, et al. Randomized controlled trial of contingency management for stimulant use in community mental health patients with serious mental illness. American Journal of Psychiatry 2013;170(1):94‐101. [CSzG: 24857] - PMC - PubMed
    1. Murphy SM, McDonell MG, McPherson S, Srebnik D, Angelo F, Roll JM, et al. An economic evaluation of a contingency‐management intervention for stimulant use among community mental health patients with serious mental illness. Drug and Alcohol Dependence 2015;153:293‐9. [CSzG: 29903] - PMC - PubMed
    1. NCT00809770. Contingency management of psychostimulant abuse in the severely mentally ill. ClinicalTrials.gov 2008. [CSzG: 17380]
    1. Weiss RD. Contingency management for patients with serious mental illness and stimulant dependence. American Journal of Psychiatry 2013;170(1):6‐8. - PubMed
McDonell 2017 {published and unpublished data}
    1. Lowe JM, McDonell MG, Leickly E, Angelo FA, Vilardaga R, McPherson S, et al. Determining ethyl glucuronide cutoffs when detecting self‐reported alcohol use in addiction treatment patients. Alcoholism: Clinical and Experimental Research 2015;39(5):905‐10. - PMC - PubMed
    1. McDonell MG, Leickly E, McPherson S, Skalisky J, Hirchak K, Oluwoye O, et al. Pretreatment ethyl glucuronide levels predict response to a contingency management intervention for alcohol use disorders among adults with serious mental illness. American Journal on Addictions 2017;26(7):673‐5. [CSzG: 36340] - PMC - PubMed
    1. McDonell MG, Leickly E, McPherson S, Skalisky J, Srebnik D, Angelo F, et al. A randomized controlled trial of ethyl glucuronide‐ based contingency management for outpatients with co‐occurring alcohol use disorders and serious mental Illness. American Journal of Psychiatry 2017;174(4):370‐7. [CSzG: 35589] - PMC - PubMed
    1. McDonell MG, Skalisky J, Leickly E, McPherson S, Battalio S, Nepom JR, et al. Using ethyl glucuronide in urine to detect light and heavy drinking in alcohol dependent outpatients. Drug and Alcohol Dependence 2015;157:184‐7. - PMC - PubMed
    1. NCT01567943. Contingency management of alcohol abuse in the severely mentally ill. http://ClinicalTrials.gov/show/NCT01567943 2012. [CSzG: 23792]
Morse 2006 {published data only}
    1. Calsyn RJ, Yonker RD, Lemming MR, Morse GA, Klinkenberg WD. Impact of assertive community treatment and client characteristics on criminal justice outcomes in dual disorder homeless individuals. Criminal Behaviour and Mental Health 2005;15(4):236‐48. [CSzG: 16813] - PubMed
    1. Fletcher TD, Cunningham JL, Calsyn RJ, Morse GA, Klinkenberg WD. Evaluation of treatment programs for dual disorder individuals: modeling longitudinal and mediation effects. Administration and Policy in Mental Health 2008;35(4):319‐36. [CSzG: 16624; MEDLINE: ] - PubMed
    1. Morse GA, Calsyn RJ, Klinkenberg WD, Cunningham J, Lemming MR. Integrated treatment for homeless clients with dual disorders: a quasi‐experimental evaluation. Journal of Dual Diagnosis 2008;4(3):219‐37. [CSzG: 19618]
    1. Morse GA, Calsyn RJ, Klinkenberg WD, Helminiak TW, Wolff N, Drake RE, et al. Treating homeless clients with severe mental illness and substance use disorders: costs and outcomes. Community Mental Health Journal 2006;42(4):377‐404. [CSzG: 13863] - PubMed
Naeem 2005 {published data only}
    1. Naeem F, Kingdon D, Turkington D. Cognitive behaviour therapy for schizophrenia in patients with mild to moderate substance misuse problems. Cognitive Behaviour Therapy 2005;34(4):207‐15. [CSzG: 12597] - PubMed
    1. Turkington D, Kingdon D, Turner T. Effectiveness of a brief cognitive‐behavioural therapy intervention in the treatment of schizophrenia. British Journal of Psychiatry 2002;180:523‐7. [CSzG: 8740] - PubMed
Nagel 2009 {published data only}
    1. Nagel T, Robinson G, Condon J, Trauer T. Approach to treatment of mental illness and substance dependence in remote indigenous communities: results of a mixed methods study. Australian Journal of Rural Health 2009;17(4):174‐82. [CSzG: 18782; MEDLINE: ] - PubMed
O'Connell 2018 {published and unpublished data}
    1. O'Connell MJ, Flanagan EH, Delphin‐Rittmon ME, Davidson L. Enhancing outcomes for persons with co‐occurring disorders through skills training and peer recovery support. Journal of Mental Health 2018;in press:(online 10 March 2017). [CSzG: 35896; DOI: 10.1080/09638237.2017.1294733] - DOI - PubMed
Petry 2013 {published data only}
    1. NCT01478815. Contingency management for persons with severe mental illness. http://ClinicalTrials.gov/show/NCT01478815 2011. [CSzG: 23332]
    1. Petry NM, Alessi SM, Rash Carla J. A randomized study of contingency management in cocaine‐dependent patients with severe and persistent mental health disorders. Drug and Alcohol Dependence 2013;130:234‐7. [CSzG: 28275] - PMC - PubMed
Rosenblum 2014 {published data only}
    1. Rosenblum A, Matusow H, Fong C, Vogel H, Uttaro T, Moore TL, et al. Efficacy of dual focus mutual aid for persons with mental illness and substance misuse. Drug and Alcohol Dependence 2014;135:78‐87. [CSzG: 27823] - PMC - PubMed
Swanson 1999 {published data only}
    1. Pantalon MV, Swanson AJ. Use of the University of Rhode Island Change Assessment to measure motivational readiness to change in psychiatric and dually diagnosed individuals. Psychology of Addictive Behaviors 2003;17(2):91‐7. [CSzG: 9830] - PubMed
    1. Swanson AJ, Pantalon MV, Cohen KR. Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients. Journal of Nervous and Mental Disease 1999;187(10):630‐5. [CSzG: 9248] - PubMed
Tracy 2007 {published data only}
    1. Tracy K, Babuscio T, Nich C, Kiluk B, Carroll KM, Petry NM, et al. Contingency management to reduce substance use in individuals who are homeless with co‐occurring psychiatric disorders. American Journal of Drug and Alcohol Abuse 2007;33(2):253‐8. [CSzG: 14807; MEDLINE: ] - PMC - PubMed

References to studies excluded from this review

Audier 2011 {published data only}
    1. Audier C, Mulder CL, Staring A, Hoorn BE, Hakkaart‐vanRoijen L, Blanken P. Money for medication: A randomized controlled study on the effectiveness of financial incentives to improve medication adherence in patients with a psychotic disorder and co‐morbid substance abuse. Schizophrenia Bulletin 2011;1:294‐5.
Bachmann 1997 {published data only}
    1. Bachmann KM, Moggi F, Hirsbrunner HP, Donati R, Brodbeck J, Hirsbrunner H. An integrated treatment program for dually diagnosed patients. Psychiatric Services 1997;48(3):314‐6. - PubMed
Bagoien 2013 {published data only}
    1. Bagoien G, Bjorngaard J, Ostensen C, Romundstad P, Morken G. Motivational interviewing to patients with comorbid substance use admitted to an acute psychiatric department. Psychiatrische Praxis 2011;38:S10.
    1. Bagoien G, Bjorngaard JH, Ostensen C, Reitan SK, Romundstad P, Morken G. The effects of motivational interviewing on patients with comorbid substance use admitted to a psychiatric emergency unit ‐ a randomised controlled trial with two year follow‐up. BMC Psychiatry 2013;13:93. [PUBMED: 23517244] - PMC - PubMed
Barkhof 2013 {published data only}
    1. Barkhof E, Meijer CJ, Sonneville LM, Linszen DH, Haan L. The effect of motivational interviewing on medication adherence and hospitalization rates in nonadherent patients with multi‐episode schizophrenia. Schizophrenia Bulletin 2013;39(6):1242‐51. - PMC - PubMed
Barrowclough 2006b {published data only}
    1. Barrowclough C, Haddock G, Lobban F, Jones S, Siddle R, Roberts C, et al. Group cognitive‐behavioural therapy for schizophrenia. British Journal of Psychiatry 2006;189:527‐32. - PubMed
Battersby 2013 {published data only}
    1. Battersby MW, Beattie J, Pols RG, Smith DP, Condon J, Blunden S. A randomised controlled trial of the Flinders Program of chronic condition management in Vietnam veterans with co‐morbid alcohol misuse, and psychiatric and medical conditions. Australian and New Zealand Journal of Psychiatry 2013;47(5):451‐62. - PubMed
Bechdolf 2004 {published data only}
    1. Bechdolf A, Knost B, Kuntermann C, Schiller S, Klosterkotter J, Hambrecht M, et al. A randomized comparison of group cognitive‐behavioural therapy and group psychoeducation in patients with schizophrenia. Acta Psychiatrica Scandinavica 2004;110(1):21‐8. - PubMed
Beebe 2012 {published data only}
    1. Beebe LH, Smith K, Burk R, McIntyre K, Dessieux O, Tavakoli A, et al. Motivational intervention increases exercise in schizophrenia and co‐occurring substance use disorders. Schizophrenia Research 2012;135(1‐3):204‐5. - PubMed
Bell 2011 {published data only}
    1. Bell MD. Cognitive remediation with work therapy in the initial phase of substance abuse treatment. Schizophrenia Bulletin 2011;Suppl 1:296.
Bennett 2001 {published data only}
    1. Bennett ME, Bellack AS, Gearon JS. Treating substance abuse in schizophrenia. An initial report. Journal of Substance Abuse Treatment 2001;20:163‐75. - PubMed
Bowen 2000 {published data only}
    1. Bowen RC, D'Arcy C, Keegan D, Senthilselvan A. A controlled trial of cognitive behavioural treatment of panic in alcoholic inpatients with comorbid panic disorder. Addictive Behaviours 2000;25(4):593‐7. - PubMed
Brooner 2013 {published data only}
    1. Brooner RK, Kidorf MS, King VL, Peirce J, Neufeld K, Stoller K, et al. Managing psychiatric comorbidity within versus outside of methadone treatment settings: a randomized and controlled evaluation. Addiction (Abingdon, England) 2013;108(11):1942‐51. - PMC - PubMed
Brown 2015 {published data only}
    1. Brown RA, Abrantes AM, Minami H, Prince MA, Bloom EL, Apodaca TR, et al. Motivational interviewing to reduce substance use in adolescents with psychiatric comorbidity. Journal of Substance Abuse Treatment 2015;59:20‐9. - PMC - PubMed
Carey 2004 {published and unpublished data}
    1. Carey KB, Purnine DM, Maisto SA, Carey MP. Enhancing readiness‐to‐change substance abuse in persons with schizophrenia. A four‐session motivation‐based intervention. Behaviour Modification 2001;25(3):331‐84. - PMC - PubMed
    1. Carey MP, Carey KB, Maisto SA, Gordon CM, Schroder KE, Vanable PA. Reducing HIV‐risk behavior among adults receiving outpatient psychiatric treatment: Results from a randomized controlled trial. Journal of Consulting and Clinical Psychology 2004;72(2):252‐68. - PMC - PubMed
Castle 2002 {published and unpublished data}
    1. ACTRN12610000249055. A randomised control trial of a group based intervention and relapse prevention package for substance misuse and psychosis. Australian New Zealand Clinical Trials Registry 2010.
    1. Castle DJ, James W, Koh G, Kisely N, Preston N. An RCT A group‐based intervention for substance abuse in schizophrenia. Schizophrenia Research 2003;60:276‐7.
    1. Castle DJ, James W, Koh G, Wightman P, Kisely S, Spencer C, et al. Substance use in schizophrenia: why do people use, and what can be done about it?. Schizophrenia Research 2002;53(3 Suppl 1):178.
Clarke 2000 {published data only}
    1. Clarke GN, Herinckz HA, Kinney RF, Paulson RI, Cutler DL, Lewis K, et al. Psychiatric hospitalizations, arrests, emergency room visits, and homelessness of clients with serious and persistent mental illness: Findings from a randomized trial of two ACT programs vs. usual care. Mental Health Services Research 2000;2(3):155‐64. - PubMed
Clausen 2016 {published data only}
    1. Clausen H, Ruud T, Odden S, Saltytė Benth J, Heiervang KS, Stuen HK, et al. Hospitalisation of severely mentally ill patients with and without problematic substance use before and during Assertive Community Treatment: an observational cohort study. BMC Psychiatry 2016;16:125. - PMC - PubMed
DeMarce 2008 {published data only}
    1. DeMarce JM, Lash SJ, Stephens RS, Grambow SC, Burden JL. Promoting continuing care adherence among substance abusers with co‐occurring psychiatric disorders following residential treatment. Addictive Behaviors 2008;33(9):1104‐12. [MEDLINE: ] - PubMed
de Waal 2015 {published data only}
    1. Waal MM, Kikkert MJ, Blankers M, Dekker JJ, Goudriaan AE. Self‐wise, Other‐wise, Streetwise (SOS) training: a novel intervention to reduce victimization in dual diagnosis psychiatric patients with substance use disorders: protocol for a randomized controlled trial. BMC Psychiatry 2015;15:267. [NTR 4472] - PMC - PubMed
Drake 2004a {published data only}
    1. Drake RE, Xie X, McHugo GJ, Shumway M. Three‐year outcomes of long‐term patients with co‐occurring bipolar and substance use disorders. Biological Psychiatry 2004;56(November 15):749‐56. - PubMed
Drake 2006 {published data only}
    1. Drake RE, McHugo GJ, Xie H, Fox M, Packard J, Helmsetter B. Ten‐year recovery outcomes for clients with co‐occurring schizophrenia and substance use disorders. Schizophrenia Bulletin. 2006;32(3):464‐73. - PMC - PubMed
Drebing 2005 {published data only}
    1. Drebing CE, Ormer EA, Krebs C, Rosenheck R, Rounsaville B, Herz L, et al. The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans. Journal of Applied Behavior Analysis 2005;38(3):359‐72. - PMC - PubMed
Drebing 2007 {published data only}
    1. Drebing CE, Ormer EA, Mueller L, Hebert M, Penk WE, Petry NM, et al. Adding contingency management intervention to vocational rehabilitation: outcomes for dually diagnosed veterans. Journal of Rehabilitation Research and Development 2007;44(6):851‐65. [MEDLINE: ] - PubMed
Eberhard 2009 {published data only}
    1. Eberhard S, Nordstrom G, Hoglund P, Ojehagen A. Secondary prevention of hazardous alcohol consumption in psychiatric out‐patients: a randomised controlled study. Social Psychiatry and Psychiatric Epidemiology 2009;12:1013‐21. - PubMed
Faber 2012 {published data only}
    1. Faber G, Smid HG, Gool AR, Wunderink L, Bosch RJ, Wiersma D. Continued cannabis use and outcome in first‐episode psychosis: Data from a randomized, open‐label, controlled trial. Journal of Clinical Psychiatry 2012;73(5):632‐8. - PubMed
Fiszdon 2016 {published data only}
    1. Fiszdon JM, Kurtz MM, Choi J, Bell MD, Martino S. Motivational interviewing to increase cognitive rehabilitation adherence in schizophrenia. Schizophrenia Bulletin 2016;42(2):327‐34. - PMC - PubMed
Gaughran 2017 {published data only}
    1. Gaughran F, Stahl D, Ismail K, Atakan Z, Lally J, Gardner‐Sood P, et al. Improving physical health and reducing substance use in psychosis‐‐randomised control trial (IMPACT RCT): study protocol for a cluster randomised controlled trial. BMC Psychiatry 2013;13:263. - PMC - PubMed
    1. Gaughran F, Stahl D, Ismail K, Greenwood K, Atakan Z, Gardner‐Sood P, et al. Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT). BMC Psychiatry 2017;17(1):413. - PMC - PubMed
    1. Smith S, Greenwood K, Atakan Z, Sood P, Ohlsen R, Papanastasiou E, et al. The impact study ‐ motivating a change in health behaviour. European Psychiatry. 2011; Vol. 26, issue (Suppl 1):2151.
Gleesen 2009 {published data only}
    1. Alvarez‐Jimenez M, Gleeson J, Cotton S, Wade D, Gee D, Pearce T, et al. Duration of untreated psychosis, insight and adherence with cognitive‐behavioural therapy in first‐episode psychosis. Early Intervention in Psychiatry 2008;2(Suppl 1):A101.
    1. Cotton SM, Gleeson JF, Alvarez‐Jimenez M, McGorry PD. Quality of life in patients who have remitted from their first episode of psychosis. Schizophrenia Research 2010;121(1‐3):259‐65. - PubMed
    1. Gleeson J, Alvarez‐Jimenez M, Killackey E, McGorry P. Two year outcomes from the episode ii trial. Early Intervention in Psychiatry 2010;4(Suppl 1):24.
    1. Gleeson J, Cotton S, Alvarez‐Jimenez M, Wade D, Gee D, Crisp K, et al. An RCT of relapse prevention therapy for first‐episode psychosis patients. Early Intervention in Psychiatry 2008;2(Suppl 1):A20.
    1. Gleeson J, Wade D, Castle D, Gee D, Crisp K, Pearce T, et al. The EPISODE II trial of cognitive and family therapy for relapse prevention in early psychosis: rationale and sample characteristics. Journal of Mental Health 2008;17(1):19‐32.
Goldstein 2005 {published data only}
    1. Goldstein G, Haas GL, Shemansky WJ, Barnett B, Salmon‐Cox S. Rehabilitation during alcohol detoxication in comorbid neuropsychiatric patients. Journal of Rehabilitation Research and Development 2005;42(2):225‐34. [MEDLINE: ] - PubMed
Harrison 2017 {published data only}
    1. Harrison J, Curtis A, Cousins L, Spybrook J. Integrated dual disorder treatment implementation in a large state sample. Community Mental Health Journal 2017;53(3):358‐66. - PubMed
Havassy 2000 {published data only}
    1. Havassy BE, Shropshire MS, Quigley LA. Effects of substance dependence on outcomes of patients in a randomized trial of two case management models. Psychiatric Services 2000;51(5):639‐44. - PubMed
Herman 2000 {published and unpublished data}
    1. Herman SE, BootsMiller B, Jordan L, Mowbray CT, Brown G, Deiz N, et al. Immediate outcomes of substance abuse treatment within a state psychiatric hospital. Journal of Mental Health Administration 1997;24(2):126‐38. - PubMed
    1. Herman SE, Frank KA, Mowbray CT, Ribisl K, Davidson WS, BootsMiller B, et al. Longitudinal effects of integrated treatment on alcohol use for persons with serious mental illness and substance use disorders. Journal of Behavioral Health Services and Research 2000;27(3):286‐302. - PubMed
Hulse 2002 {published data only}
    1. Hulse GK, Tait RJ. Six‐month outcomes associated with a brief alcohol intervention for adult in‐patients with psychiatric disorders. Drug and Alcohol Review 2002;21(2):105‐12. - PubMed
ISRCTN58667926 {published data only}
    1. ISRCTN58667926. Impact ‐ improving physical health and reducing substance use in severe mental illness: randomised controlled trial of a health promotion intervention. http://public.ukcrn.org.uk/ 2011.
James 2004 {published data only}
    1. James W, Preston NJ, Koh G, Spencer C, Kisely SR, Castle DJ. A group intervention which assists patients with dual diagnosis reduce their drug use: a randomized controlled trial. Psychological Medicine 2004;34(6):983‐90. - PubMed
Jerrell 2000 {published data only}
    1. Jerrell JM, Wilson JL, Hiller DC. Issues and outcomes in integrated treatment programs for dual disorders. Journal of Behavioral Health Services & Research 2000;27(3):303‐13. - PubMed
Kelly 2002 {published data only}
    1. Kelly JF, McKellar JD, Moos R. Major depression in patients with substance use disorders: relationship to 12‐step self‐help involvement and substance use outcomes. Addiction 2003;98(4):499‐508. - PubMed
Kidorf 2013 {published data only}
    1. Kidorf M, Brooner RK, Gandotra N, Antoine D, King V L, Peirce J, et al. Reinforcing integrated psychiatric service attendance in an opioid‐agonist program: A randomized and controlled trial. Drug and Alcohol Dependence 2013;133(1):30‐6. - PMC - PubMed
    1. Kidorf M, King VL, Peirce J, Gandotra N, Ghazarian S, Brooner RK. Substance use and response to psychiatric treatment in methadone‐treated outpatients with comorbid psychiatric disorder. Journal of Substance Abuse Treatment 2015;51:64‐9. - PMC - PubMed
Killackey 2013 {published data only}
    1. Allott KA, Chinnery GL, Cotton SM, Jackson HJ, Killackey EJ. Does individual placement and support compensate for neurocognitive deficit in first‐episode psychosis?. Early Intervention in Psychiatry 2012;6:14.
    1. Arnold C, Allott K, Farhall J, Killackey E, Cotton S. Neurocognitive and social cognitive predictors of cannabis use in first‐episode psychosis. Schizophrenia Research 2015;168(1‐2):231‐7. - PubMed
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NCT00447720 {published data only}
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NCT00495911 {published data only}
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NCT01361698 {published data only}
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Shorey 2015 {published data only}
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Sitharthan 1999 {published data only}
    1. Sitharthan T, Singh S, Kranitis P, Currie J, Freeman P, Murugesan G, et al. Integrated drug and alcohol intervention: development of an opportunistic intervention program to reduce alcohol and other substance use among psychiatric patients. Australian and New Zealand Journal of Psychiatry 1999;33(5):676‐83. [MEDLINE: ] - PubMed
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    1. NCT01167556. Family motivational intervention in schizophrenia. http://ClinicalTrials.gov/show/NCT01167556 2006.
    1. Smeerdijk M, Keet R, Haan L, Schippers G, Linszen D. Family motivation intervention in early onset psychosis and cannabis abuse: a randomized clinical trial. Proceedings of the 12th International Congress on Schizophrenia Research; 2009 Mar 28‐Apr 1; San Diego, CA. Oxford Univ Press, 2009:371.
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Somers 2015 {published data only}
    1. Cheung A, Somers JM, Moniruzzaman A, Patterson M, Frankish CJ, Krausz M, et al. Emergency department use and hospitalizations among homeless adults with substance dependence and mental disorders. Addiction Science and Clinical Practice 2015;10:17. [ISRCTN575077 and 66721740] - PMC - PubMed
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Weiss 2000 {published data only}
    1. Weiss RD, Griffin ML, Greenfield SF, Najavits LM, Wyner D, Soto JA, et al. Group therapy for patients with bipolar disorder and substance dependence: results of a pilot study. Journal of Clinical Psychiatry 2000;61(5):361‐7. - PubMed
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    1. Weiss RD, Griffin ML, Kolodziej ME, Greenfield SF, Najavits LM, Daley DC, et al. A randomized trial of integrated group therapy versus group drug counseling for patients with bipolar disorder and substance dependence. American Journal of Psychiatry 2007;164(1):100‐7. - PubMed
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References to studies awaiting assessment

ACTRN12616000275460 {published data only}
    1. Solar A, Chamber J. A clinical study comparing more time intensive therapy with experienced alcohol and drug nurse clinicians to a Brief Information Pack for patients on a mental health unit and alcohol and drug disorders in linking to the community alcohol and drug rehabilitation service of their choice. International Clinical Trials Registry Platform 2016;1:1‐2. [ACTRN126160000275460]
Gurevich 2015 {published data only}
    1. Gurevich GL, Agibalova TV, Rychkova OV, Buzik OZ. Pychotherapy in patients with alcohol dependence and comorbid endogenous pathology. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova 2015;115(4 Pt 2):28‐33. - PubMed
Meister 2010 {published data only}
    1. Meister K, Rietschel L, Burlon M, Jannsen H, Bock T, Wegscheider K, et al. A cluster‐randomized, parallel group, observer blind trial of a group based motivational‐behavioural therapy for young people with psychosis and substance use disorder. Early Intervention in Psychiatry 2010;4 Suppl 1:163.
    1. Meister, K. Comorbid psychosis and addiction. Epidemiology, explanatory models and evaluation of motivational behavioural group therapy [Komorbidität psychose und sucht. Epidemiologie, erklärungsmodelle und evaluation einer motivational‐verhaltenstherapeutischen gruppentherapie]. Dissertation, University of Hamburg 2010.
NCT01883791 {published data only}
    1. NCT01883791. Screening, Brief Intervention and Referral to Treatment for substance abuse in mental health treatment settings (SBIRT in MH). https://ClinicalTrials.gov/show/NCT01883791 2017.
    1. Spear SE, Karno M, Glasner‐Edwards S, Rawson R, Saitz R, Dominguez B. Applying SBIRT to new settings: Preliminary findings of substance use disorder risk in community mental health settings. Drug and Alcohol Dependence 2015;156:e209.
NCT02214667 {published data only}
    1. NCT02214667. Treating co‐occurring substance use and mental disorders among jail inmates. http://Clinicaltrials.gov/show/NCT02214667 2015.
    1. Dorn RA, Desmarais SL, Rade CB, Burris EN, Cuddeback GS, Johnson KL, et al. Jail‐to‐community treatment continuum for adults with co‐occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial. Trials 2017;18(1):365. - PMC - PubMed
NCT02319746 {published data only}
    1. Gonzalez‐Ortega I, Echeburua E, Garcia‐Alocen A, Vega P, Gonzalez‐Pinto A. Cognitive behavioral therapy program for cannabis use cessation in first‐episode psychosis patients: study protocol for a randomized controlled trial. Trials 2016;17:372. - PMC - PubMed
    1. NCT02319746. Cognitive behavioral therapy program to first‐episode psychosis patients and cannabis abuse. https://Clinicaltrials.gov/ct2/show/NCT02319746 2014.
NCT02670902 {published data only}
    1. NCT02670902. Intervention for persons leaving residential substance abuse treatment. https://ClinicalTrials.gov/show/NCT02670902 2016.
NCT03007940 {published data only}
    1. NCT03007940. Using NIATx strategies to implementiIntegrated services in routine care. https://ClinicalTrials.gov/show/NCT03007940 2016.

References to ongoing studies

Bennett 2007 {published data only}
    1. Bennett M, Bellack AS, Dixon L. Treatment of alcohol use disorders in people with severe mental illness. Schizophrenia Bulletin 2007;33(2):421.
    1. NCT00280813. Treatment of alcohol use disorders in schizophrenia. http://www.clinicaltrials.gov 2006.
CIRCLE trial {published data only}
    1. ISRCTN33576045. Contingency intervention for reduction of cannabis in early psychosis ‐circle. http://www.controlled‐trials.com 2011.
    1. ISRCTN33576045. Randomised controlled trial of the clinical and cost‐effectiveness of a contingency management intervention for reduction of cannabis use and of relapse in early psychosis. Circle. http://public.ukcrn.org.uk/ 2012.
    1. Johnson S, Sheridan Rains L, Marwaha S, Strang J, Craig T, Weaver T, et al. A randomised controlled trial of the clinical and cost‐effectiveness of a contingency management intervention compared to treatment as usual for reduction of cannabis use and of relapse in early psychosis (CIRCLE): a study protocol for a randomised controlled trial. Trials 2016;17(1):515. - PMC - PubMed
NCT00783185 {published data only}
    1. NCT00783185. Dual diagnosis (psychosis and cannabis misuse): comparison of specialized treatment versus unspecified treatment. http://www.clinicaltrials.gov 2008.
NCT00798109 {published data only}
    1. NCT00798109. Effect of motivational therapy on schizophrenia with cannabis misuse. http://www.clinicaltrials.gov 2008.
Verstappen 2007 {published data only}
    1. Verstappen N, Henquet C. Effects and indicators of CBT for cannabis use in psychosis [Studie naar 'Behandeling cananbisgebruik en psychose']. http://www.trialregister.nl/trialreg/index.asp 2007.

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