Two of the papers in the current issue focus on homelessness. This is a common and unfortunate cooccurring condition in dual diagnosis patients. Psychiatric illnesses are associated with high rates of tobacco use. Harris et al. used multivariate logistic regression to explore predictors of tobacco use in homeless persons. Variables associated with tobacco use included psychiatric illness and illicit substance use. The paper by Sch€ utz et al. highlights how commonly dual diagnosis conditions are found in homeless persons. In this report, the authors assessed homeless people with a standard diagnostic assessment instrument. Of the 500 participants, about 10% had a psychiatric illness, 28% a substance use disorder, 55% both, and only 7% did not have a psychiatric illness. Contractor et al. used best-fitting latent class modeling to categorize people based on posttraumatic stress disorder (PTSD) symptoms and substance use. In the 375 participants who responded to an Internet crowdsourcing site, three groups were identified: low PTSD and substance use, moderate PTSD and drug use with high alcohol use, and high PTSD and substance use. The authors suggest that identifying these groups will lead to a better understanding of PTSD and substance use comorbidity. Impulsivity has been linked to substance use in many studies. Risi et al. examined alcohol use in 287 undergraduates at a historically Black university. The authors report that impulsivity mediated the relationship been psychological distress and alcohol misuse in these students. The findings suggest that impulsivity might be a target for interventions in this student population. Nalmefene is a drug that acts on the opioid receptor that is currently available in Europe and was previously available in the United States. Salles et al. present a case report of a patient with schizoaffective disorder and alcohol use disorder who quickly experienced a worsening of psychotic symptoms when receiving nalmefene. The findings suggest the possibility of the development of or worsening of psychotic symptoms when receiving this class of medications.

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社论

本期有两篇论文关注无家可归问题。这是双重诊断患者中常见且不幸的同时发生的情况。精神疾病与烟草使用率高有关。哈里斯等人。使用多变量逻辑回归来探索无家可归者烟草使用的预测因素。与烟草使用相关的变量包括精神疾病和非法物质使用。Sch€utz 等人的论文。强调了在无家可归者中发现双重诊断条件的普遍程度。在这份报告中，作者使用标准诊断评估工具评估了无家可归者。在 500 名参与者中，大约 10% 有精神疾病，28% 有物质使用障碍，55% 两者都有，只有 7% 没有精神疾病。承包商等。使用最适合的潜在类模型根据创伤后应激障碍 (PTSD) 症状和物质使用对人进行分类。在对互联网众包网站做出回应的 375 名参与者中，确定了三组：低度 PTSD 和物质使用、中度 PTSD 和药物使用与大量饮酒，以及高 PTSD 和物质使用。作者建议，识别这些群体将有助于更好地了解 PTSD 和物质使用合并症。在许多研究中，冲动与物质使用有关。里西等人。调查了一所历史悠久的黑人大学 287 名本科生的酒精使用情况。作者报告说，冲动介导了这些学生的心理困扰和酒精滥用之间的关系。研究结果表明，冲动可能是对这一学生群体进行干预的目标。纳美芬是一种作用于阿片受体的药物，目前在欧洲有售，之前在美国有售。萨勒斯等人。提供一例患有分裂情感性障碍和酒精使用障碍的患者的病例报告，该患者在接受纳美芬后迅速出现精神病症状。研究结果表明，在接受此类药物治疗时，可能会出现精神病症状或使精神病症状恶化。