In the current issue, three reports involve tobacco smoking. In a modest-sized open-label study by Cather et al. of varenicline and cognitive behavioral therapy for patients with schizophrenia undergoing treatment for smoking cessations, for the sample as a whole, symptoms of depression did not increase during the trial. Although some patients experienced symptom increases, this study provides additional evidence of the relative safety of this approach for patients with schizophrenia.
An interesting online survey of family members of individuals with mental illness by Aschenbrenner et al. revealed that among those completing the survey, there was uncertainty about both the effect of smoking on mental illness and the safety of cessation treatments. The data give some indication that treatment programs for smoking cessation in this population might benefit from including family members to enhance treatment success.
Although smoking in patients with irritable bowel syndrome (IBS) has been the topic of study in the medical literature, a review of the rates of smoking in those with IBS by Sirri et al. did not suggest an increased rate of smoking in those with IBS.
There are three reports involving veterans. A paper by Shiner et al., employing administrative and pharmacy data from the U.S. Veterans Administration for the years 2003 to 2013, noted an increase in opioid use disorder in those with posttraumatic stress disorder (PTSD). Moreover, during this period, use of buprenorphine as a treatment increased, compared to the use of methadone. The authors point out the importance of identifying and treating opioid use disorder in this population.
A small exploratory study by Flanagan et al. raised the issue of dyadic personal relationships as a factor in the treatment of PTSD with co-occurring substance use disorders among veterans. The data suggest that problematic relationships at baseline are associated with less improvement of PTSD symptoms. Further research studies are suggested.
A study of treatment for patients with PTSD and co-occurring alcohol use disorders in a sample of veterans assessed sexual side effects in those receiving either paroxetine or desipramine, with or without the addition of naltrexone. The data suggested that sexual side effects were not different in those receiving paroxetine versus desipramine. Of interest, the addition of naltrexone in either group did not decrease such side effects, and there was even the suggestion that those receiving naltrexone were somewhat more likely to report such effects.
Last, the report by Cherner et al. involves a study of Housing First, a Canadian program that prioritizes housing for individuals with homelessness and problematic substance use. The report showed that these individuals can be successfully housed in such a program. Nonetheless, relative to a comparison group, assessments of substance use in the Housing First group were not improved. Differences in sample selection for the two groups might have contributed to the findings, and further research is clearly indicated to study the effects of this interesting program.