Psychiatric morbidity and protracted symptoms after COVID-19.

We investigated the psychiatric symptomatology and the protracted symptoms in patients who had recovered from the acute COVID-19 infection. Two hundred and eighty-four patients completed a web-based or a paper survey on socio-demographic and clinical data. The psychiatric status was assessed using Impact of Events Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and MINI suicidality scale. Patients completed a checklist for the protracted symptoms that were experienced after the acute infection. After a mean of almost 50 days following the diagnosis, 98 patients (34.5%) reported clinically significant PTSD, anxiety, and/or depression, with PTSD being the most common condition reported (25.4%). One hundred and eighteen patients (44.3%) reported one or more protracted symptom(s). Predictors of PTSD symptom severity were the female gender, past traumatic events, protracted symptoms, stigmatization, and a negative view on the COVID-19 pandemic. PTSD symptom severity was the sole independent predictor of the protracted symptoms. Our results suggest that COVID-19 patients are prone to substantial psychological distress in the first few months after the infection. The protracted symptoms were frequent in this period, and these were closely related to the posttraumatic symptoms.

Getting patients the services they need using a computer-assisted system for patient assessment and referral--CASPAR.

The two goals of this technology transfer study were to: (1) increase the number and appropriateness of services received by substance abuse patients, and thereby (2) give clinical meaning and value to research-based assessment information. A software-based Resource Guide was developed to allow counselors to easily identify local resources for referral of their patients to additional clinical and social services. Two hours of training were provided on the use of the guide. It was hoped that this software and training would provide the counselors with a concrete method of linking the Addiction Severity Index (ASI) assessment information on patient problems to appropriate, available community services. We expected improved treatment planning, increased problem services matching, better patient-counselor rapport/satisfaction and better patient-performance during treatment. Data were analyzed from 131 patients of 33 counselors from 9 treatment programs, randomly assigned to 2 groups--Standard Assessment (SA) or Enhanced Assessment (EA). Patients of counselors in the EA group (1) had treatment plans that were better matched to their needs, (2) received significantly more and better-matched services than patients in the SA group, and (3) were less likely to leave treatment against medical advice and more likely to complete the full course of treatment than patients of counselors in the SA group. They did not have higher levels of patient satisfaction or helping alliance scores. These findings are discussed with regard to integrating empirically supported procedures into contemporary, community-based substance abuse treatment.

Developing CASPAR: a computer-assisted system for patient assessment and referral.

A study was completed on the use of a computer-based system that provided counselors with resources for client referrals to free or low-cost services within the community based on problems identified with an Addiction Severity Index (ASI) assessment. That study, completed in Philadelphia, found that in comparison with clients whose counselors received a standard ASI assessment training, clients whose counselors also received brief training on the simple, easy-to-use computer-based resource guide (RG) had treatment plans that were substantially better-matched to their presenting problems and received significantly more and better-matched services. Because of these favorable results, the current article presents further data on counselor use of the RG and, to facilitate the implementation of these procedures by others, we provide access to the original RG database, describe the steps necessary to develop, and maintain an RG, and provide training suggestions.

A successful researcher-practitioner collaboration in substance abuse treatment.

The best efforts to improve substance abuse treatment come from the integration of practice and research. The purpose of this article is to discuss factors that contribute to fruitful research-practice collaborations using the example of our recent successful partnership between a group of treatment researchers and a group of substance abuse recovery houses operated by Fresh Start. The research effort was the Drug Evaluation Network System, a computer assisted method of integrating clinical research and policy relevant information into a standard admission interview. The article discusses several factors that were important in integrating this research effort into the treatment system. These factors included adequate advance preparation of clinical and research staff to employ the new system, overcoming bilateral biases, and determining the degree to which the clinicians' and researchers' missions are matched. The paper also discusses a range of general factors to consider in implementing and maintaining successful research-to-practice integrations.