RESUMO
OBJECTIVES: : The impact of intramuscular, injectable, extended-release naltrexone (XR-NTX; Vivitrol) on counseling and support group participation was examined in a post hoc analysis of a 24-week, randomized, double-blind study in 624 alcohol-dependent adults, most of whom were nonabstinent at baseline. METHODS: : Patients were offered 6 monthly injections of XR-NTX 380 mg, XR-NTX 190 mg, or placebo (n = 205, 210, and 209, respectively) and 12 sessions of manualized brief counseling. Voluntary participation in extramural counseling (eg, couples or family therapy) and self-help support groups (eg, Alcoholics Anonymous) was permitted and assessed. RESULTS: : The proportion of patients attending all 12 Biopsychosocial, Report, Empathy, Needs, Direct advice, and Assessment sessions was nonsignificantly greater for XR-NTX 380 mg (45%) than for placebo (39%), as was the proportion attending extramural counseling (10% vs 7%) and support groups (13% vs 10%). Attendance rates were intermediate with XR-NTX 190-mg. Attending self-help groups was significantly (P = 0.04) related to reduced heavy drinking across all treatment groups. CONCLUSIONS: : XR-NTX is compatible with counseling and support group participation in the treatment of alcohol dependence.
RESUMO
Substance use disorders and sleep disorders are among the most common psychiatric problems in children and adolescents. They often co-occur and have a significant negative effect upon normal development. This article provides a review of the most recent literature on the relationship between these disorders, along with recommendations on how to recognize and clinically address these disorders in children and adolescents.