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Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

The purpose of this paper is to estimate the share of multiple substance disorders among clients entering treatment for substance-related problems, to identify the most frequent combinations of the substances involved and to investigate the profiles of the clients involved.

Data were taken from the Swiss treatment monitoring system act-info applied among inpatient and outpatient facilities (reporting years 2013–2015). All cases with information on multiple substance disorders, according to a definition close to the diagnosis F19 from the ICD-10 classification of disease were included. The measurements comprised designated primary substance, existing multiple substance use disorder, substances involved and basic socio-demographics.

From 10,009 clients included in the study, 1,653 (16.5 per cent) were reported as having multiple substance use disorders. A great variety of substance combinations was identified and alcohol was found in the majority of them.

Treatment strategies targeting accurately substance-related disorders as a whole complex should be promoted. In particular the alcohol-related aspect of the disorder should not be neglected when the focus is on illegal drugs.

Multiple substance use was until recently not sufficiently documented in treatment monitoring systems. A recent version of the European treatment demand indicator (TDI) has introduced the notion of “polydrug use problem” as complementary information to the primary substance, which remains the key variable for reporting treatment demand. This study represents a first attempt to explore systematically this new data.

The purpose of this paper is to review the evidence of alcohol use disorders within the different stages of the criminal justice system in the UK. Furthermore it reviewed the worldwide evidence of alcohol brief interventions in the various stages of the criminal justice system.

A rapid systematic review of publications was conducted from the year 2000 to 2014 regarding the prevalence of alcohol use disorders in the various stages of the criminal justice system. The second part of the work was a rapid review of effectiveness studies of interventions for alcohol brief interventions. Studies were included if they had a comparison group. Worldwide evidence was included that consisted of up to three hours of face-to-face brief intervention either in one session or numerous sessions.

This review found that 64-88 per cent of adults in the police custody setting; 95 per cent in the magistrate court setting; 53-69 per cent in the probation setting and 5,913-863 per cent in the prison system and 64 per cent of young people in the criminal justice system in the UK scored positive for an alcohol use disorder. There is very little evidence of effectiveness of brief interventions in the various stages of the criminal justice system mainly due to the lack of follow-up data.

Brief alcohol interventions have a large and robust evidence base for reducing alcohol use in risky drinkers, particularly in primary care settings. However, there is little evidence of effect upon drinking levels in criminal justice settings. Whilst the approach shows promise with some effects being shown on alcohol-related harm as well as with young people in the USA, more robust research is needed to ascertain effectiveness of alcohol brief interventions in this setting.

This paper provides evidence of alcohol use disorders in the different stages of the criminal justice system in the UK using a validated tool as well as reviewing the worldwide evidence for short ( < three hours) alcohol brief intervention in this setting.

This paper explores the background principles, theories, and components of the QuikFix intervention for primary and comorbid substance use in young people.

QuikFix is a brief Motivational Interviewing (MI) intervention utilising cognitive-behavioural coping skills training to reduce vulnerability to substance use and comorbid mental health problems in young people. It is delivered in two to three brief sessions including an assessment. A new version, QuikFix PI (Personality Intervention) which incorporates coping skills training targeting, sensation seeking, impulsive, depressive and anxiety personality styles that may underlie primary and comorbid substance use problems is presented.

The original QuikFix intervention has demonstrated efficacy in young alcohol and cannabis users with comorbid depression and anxiety symptoms. The efficacy of the new personality targeted version of QuikFix is currently being tested in a large randomized controlled trial among young people with alcohol related injuries/illnesses. Future research is required to determine the efficacy of QuikFix PI in comorbid populations including those with behavioural disorders.

QuikFix interventions can be delivered via telephone or face-to-face in clinical settings for clients with primary substance use and comorbid depression and anxiety symptoms.

This paper describes a novel two to three session manualised personality targeted substance use intervention. The full original QuikFix treatment manual is available online (Hides and Carroll 2010).

The assessment of patterns in risky drinking and its association with dual diagnosis in community services for older people remains under-explored. The paper aims to discuss this issue.

Drinking risk using the Alcohol Use Disorders Identification Test (AUDIT) and the presence of co-existing mental disorders was examined in 190 people aged 65 and over.

In total, 24 per cent of drinkers drank above lower risk levels and 22 per cent reported binge drinking over the past 12 months. Those scoring 1 or more on the AUDIT were more likely to be male and to have greater cognitive impairment than non-drinkers and those reporting no past problems with alcohol.

Given the limitations of the Mini Mental State Examination in the detection of alcohol related cognitive impairment (ARCI), the use of other cognitive screening instruments in larger study populations is also warranted.

Greater attention needs to be paid to the assessment of risky drinking in older male drinkers and those with cognitive impairment.

There is considerable scope for the routine detection of cognitive impairment and dementia in older people with alcohol use within mainstream mental health services, particularly in those with binge drinking. As ARCI is associated with loss of function and independence, early detection and intervention can improve health and social outcomes.

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use.

Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders.

In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005).

The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers.

A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.

This study investigated disparities in dual diagnosis (comorbid substance use and depressive/anxiety disorders) among US adults by nativity and racial–ethnic origin and socioeconomic, cultural, and psychosocial factors that may account for the observed disparities.

The study drew on data from two waves of the National Epidemiological Survey on Alcohol and Related Conditions. Racial–ethnic categories included African, Asian/Pacific Islander, European, Mexican, Puerto Rican, and other Hispanic/Latino. Substance use and depressive/anxiety disorders were assessed per DSM-IV. A four-category measure of comorbidity was constructed: no substance use or psychiatric disorder; substance use disorder only; depressive/anxiety disorder only; and dual diagnosis. The data were analyzed using multinomial logistic regression.

The prevalence of dual diagnosis was low but varied by nativity, with the highest rates among Europeans and Puerto Ricans born in US states, and the lowest among Mexicans and Asians/Pacific Islanders. The nativity and racial–ethnic effects on likelihood of having dual diagnosis remained significant after all adjustments.

The limitations included measures of immigrant status, race–ethnicity, and stress and potential misdiagnosis of mental disorder among ethnic minorities.

This new knowledge will help to guide public health and health care interventions addressing immigrant mental and behavioral health gaps.

This study addressed the research gap in regard to the prevalence and correlates of dual diagnosis among immigrants and racial–ethnic minorities. The study used the most current and comprehensive data addressing psychiatric conditions among US adults and examined factors rarely captured in epidemiologic surveys (e.g., acculturation).

The annual cost of alcohol‐related harm in the UK is estimated to be between £17.7 and £25.1 billion with healthcare costs alone reaching £2.7 billion and the costs of alcohol‐fuelled crime and disorder accounting for £7.3 billion each year. The aim of the study was to examine the prevalence of alcohol use disorders (AUD) in prison and probation settings in the North East of England, and to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) and Offender Assessment System (OASys) at identifying alcohol‐related need in probation clients. A quantitative prevalence study was carried out using anonymous questionnaires with participants from four prisons and three probation offices in the North East who voluntarily completed the AUDIT questionnaire during a 1‐month period in 2006. Response outcomes on AUDIT were compared with OASys scores which identify alcohol‐related need in probation. At the time of the study OASys scores were not available for offenders in prison. Seven hundred and fifteen questionnaires were completed. Sixty‐three per cent of men and 57% of women were identified as having an AUD with over a third of all individuals scoring within the possibly dependant range (20+ on AUDIT). Around 40% of probation cases who were classified as either hazardous, harmful or possibly dependant drinkers on AUDIT were not identified by OASys. The results indicate that the prevalence of AUD in offenders is much higher than in the general population. In addition, current methods of identifying offenders with alcohol‐related need in probation are flawed and as many such people go undetected. Alcohol assessment procedures need to be improved in criminal justice setting order to correctly identify people with AUD.

Assessment of personality disorders in substance abusing patients may produce important insights. Little is known about the value of routine personality disorder assessment in a clinical context. Adults with past‐year substance dependence seeking treatment at a centralised intake unit for substance abusers in the City of Copenhagen were randomised to assessment of personality disorders and individual psychoeducation vs. attention placebo (n=75). All patients received psychoeducation for attention deficit hyperactive disorder (ADHD) and anxiety/depression when indicated. Patients were followed at three and six months post‐treatment. The psychoeducation for personality disorder did not result in improved functioning. Significant differences indicated a larger drop in substance use in the experimental group. Assessing personality disorders and providing psychoeducation is a promising treatment in a clinical context. There is a need for relevant treatment options to improve functioning and quality of life for this group of patients.