2021
Who Uses Veterans Mental Health Services?
Manhapra A, Stefanovics EA, Rhee TG, Rosenheck RA. Who Uses Veterans Mental Health Services? The Journal Of Nervous And Mental Disease 2021, 209: 702-709. PMID: 33993183, DOI: 10.1097/nmd.0000000000001369.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationPosttraumatic stress disorderHealth service usersMH service usersSubstance use disorder diagnosisClinical practice guidelinesMental health servicesMental health service usersClinical characteristicsMedicaid insurancePain interferenceService usersBlack raceSimilar prevalenceMental health researchMH researchPractice guidelinesGreater prevalenceHealth AdministrationHealth servicesPTSD diagnosisRacial distributionMH statusStress disorderDisorder diagnosisImpact of COVID-19–Related Social Distancing on Delivery of Intensive Case Management
Rosenheck R, Johnson B, Deegan D, Stefanovics E. Impact of COVID-19–Related Social Distancing on Delivery of Intensive Case Management. The Journal Of Nervous And Mental Disease 2021, 209: 543-546. PMID: 34009864, DOI: 10.1097/nmd.0000000000001358.Peer-Reviewed Original ResearchConceptsTherapeutic allianceVeterans Affairs Medical CenterTreatment of adultsCOVID-19-Related Social DistancingSerious mental illnessIntensive case managementMore telephone contactsCommunity-based careCommunity-based treatment programsSocial distancingSelf-reported declineClinical statusTelephone contactMedical CenterService deliveryClinical status indicatorsMental illnessTreatment programCase managementFace service deliveryCOVID-19Status indicatorsVeteransParallel declineDelivery
2020
Impact of cannabis on non-medical opioid use and symptoms of posttraumatic stress disorder: a nationwide longitudinal VA study
De Aquino JP, Sofuoglu M, Stefanovics EA, Rosenheck RA. Impact of cannabis on non-medical opioid use and symptoms of posttraumatic stress disorder: a nationwide longitudinal VA study. The American Journal Of Drug And Alcohol Abuse 2020, 46: 812-822. PMID: 33035104, DOI: 10.1080/00952990.2020.1818248.Peer-Reviewed Original ResearchConceptsNon-medical opioid usePosttraumatic stress disorderOpioid useNon-medical opioidsPTSD symptomsCannabis useStress disorderSubstance useBaseline cannabis useImpact of cannabisSevere PTSD symptomsIntensive PTSD treatmentMore PTSD symptomsPTSD treatmentU.S. veteransSymptomsVA studyCannabisVeteransOpioidsSubstitution agentsBaselineDaysDisordersTreatmentGender Differences in Outcomes Following Specialized Intensive PTSD Treatment in the Veterans Health Administration
Stefanovics EA, Rosenheck RA. Gender Differences in Outcomes Following Specialized Intensive PTSD Treatment in the Veterans Health Administration. Psychological Trauma Theory Research Practice And Policy 2020, 12: 272-280. PMID: 31282719, DOI: 10.1037/tra0000495.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderTotal PTSD symptom scoresPTSD symptomsNational program evaluation dataVeterans Health AdministrationVeterans Health Administration programGreater improvementPTSD symptom scoresIntensive PTSD treatmentSymptom scoresTreatment outcomesProgram participationMale veteransGender differencesHealth AdministrationPTSD treatmentFemale veteransPTSD programProgram evaluation dataMedium effect size differencesStress disorderGender-based differencesEffect size differencesSubstance useStudy sampleInitiating Opioid Agonist Treatment for Opioid use Disorder Nationally in the Veterans Health Administration: Who Gets What?
Manhapra A, Stefanovics E, Rosenheck R. Initiating Opioid Agonist Treatment for Opioid use Disorder Nationally in the Veterans Health Administration: Who Gets What? Substance Use & Addiction Journal 2020, 41: 110-120. PMID: 31403914, DOI: 10.1080/08897077.2019.1640831.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentOpioid use disorderMethadone maintenance treatmentUse disordersOAT initiationAgonist treatmentHigher oddsMultivariate logistic regression modelVeterans Health AdministrationNational administrative dataDrug use variablesLogistic regression modelsMMT initiationPatient characteristicsIndependent predictorsMaintenance treatmentBlack raceFiscal year 2012Inpatient treatmentLower oddsBuprenorphineHealth AdministrationOpioid crisisSociodemographic characteristicsPatients
2019
Predictors of Post-Discharge Suicide Attempt Among Veterans Receiving Specialized Intensive Treatment for Posttraumatic Stress Disorder.
Stefanovics EA, Rosenheck RA. Predictors of Post-Discharge Suicide Attempt Among Veterans Receiving Specialized Intensive Treatment for Posttraumatic Stress Disorder. The Journal Of Clinical Psychiatry 2019, 80 PMID: 31412170, DOI: 10.4088/jcp.19m12745.Peer-Reviewed Original ResearchConceptsPost-discharge suicide attemptsPosttraumatic stress disorderSuicide attemptsAlcohol useSuicidal ideationStress disorderSubstance abuse comorbidityMultivariable logistic regressionNational program evaluation dataVeterans Health AdministrationAssociation of changesIntensive treatment programViolent behaviorBaseline characteristicsClinical correlatesUS veteransClinical changesIntensive treatmentHigh riskHealth AdministrationAdmissionBivariate analysisPTSD programTreatment programGreater riskComparing Outcomes of Women‐Only and Mixed‐Gender Intensive Posttraumatic Stress Disorder Treatment for Female Veterans
Stefanovics EA, Rosenheck RA. Comparing Outcomes of Women‐Only and Mixed‐Gender Intensive Posttraumatic Stress Disorder Treatment for Female Veterans. Journal Of Traumatic Stress 2019, 32: 606-615. PMID: 31361360, DOI: 10.1002/jts.22417.Peer-Reviewed Original ResearchConceptsFemale veteransMixed-gender programsOutcomes of womenNational program evaluation dataPosttraumatic stress disorder (PTSD) treatmentProgram entryLonger lengthTotal PTSD symptomsPTSD total scoreBaseline characteristicsPrimary outcomePTSD symptom levelsComparing outcomesSecondary measuresWomen veteransAssessment subscaleDisorders ProgramPosttraumatic Stress Disorder (CR for PTSD) programDisorder treatmentOutcome assessmentSuperior outcomesProgram evaluation dataPTSD symptomsSymptom levelsTotal scoreAdverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only
De Aquino JP, Sofuoglu M, Stefanovics E, Rosenheck R. Adverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only. The American Journal Of Drug And Alcohol Abuse 2019, 45: 527-537. PMID: 31112429, DOI: 10.1080/00952990.2019.1607363.Peer-Reviewed Original ResearchConceptsDrug use disordersOpioid use disorderUse disordersOpioid prescriptionsCo-occurring opioid use disordersNational Veterans Health Administration dataVeterans Health Administration dataCo-occurring opioidEmergency department visitsHealth Administration dataInpatient psychiatric admissionCannabis use disorderOpioid prescribingClinical characteristicsED visitsDepartment visitsInpatient admissionsPsychiatric admissionsFiscal year 2012Lower riskPatientsBivariate analysisAdministration dataDisordersHigher likelihoodPrevalence and multi-morbid correlates of homelessness among veterans with HIV infection nationally in the veterans health administration
Stefanovics EA, Rosenheck RA. Prevalence and multi-morbid correlates of homelessness among veterans with HIV infection nationally in the veterans health administration. Psychology Health & Medicine 2019, 24: 1123-1136. PMID: 30900465, DOI: 10.1080/13548506.2019.1595680.Peer-Reviewed Original ResearchConceptsRisk factorsNational VHA administrative dataVeterans Health Administration (VHA) servicesVHA administrative dataVeterans Health AdministrationHIV-positive veteransPreventive psychosocial interventionsHIV-positive usersHIV diagnosisHIV infectionUnadjusted riskFiscal year 2012Independent riskHigh riskHIVPsychosocial interventionsHealth AdministrationSubstantial riskIndependent effectsVeteransRiskAdministrative dataRisk of homelessnessCorrelatesInfection
2018
Opioid use disorder and homelessness in the Veterans Health Administration: The challenge of multimorbidity.
Iheanacho T, Stefanovics E, Rosenheck R. Opioid use disorder and homelessness in the Veterans Health Administration: The challenge of multimorbidity. Journal Of Opioid Management 2018, 14: 171-182. PMID: 30044482, DOI: 10.5055/jom.2018.0447.Peer-Reviewed Original ResearchConceptsOpioid use disorderVeterans Health AdministrationUse disordersAgonist therapyHomeless veteransRisk ratioRisk factorsService useHealth AdministrationOpioid agonist therapyGreater service useMajor risk factorChallenges of multimorbidityAlcohol use disorderPercent of veteransMore multimorbidityClinical correlatesVHA usersFiscal year 2012Vulnerable veteransMultimorbidityBivariate analysisGreater riskLogistic regressionMajor causeThe physical and mental health burden of obesity in U.S. veterans: Results from the National Health and Resilience in Veterans Study
Stefanovics EA, Potenza MN, Pietrzak RH. The physical and mental health burden of obesity in U.S. veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Psychiatric Research 2018, 103: 112-119. PMID: 29807318, DOI: 10.1016/j.jpsychires.2018.05.016.Peer-Reviewed Original ResearchConceptsPrevalence of obesityU.S. veteransU.S. military veteransNational HealthHealth burdenVeterans StudyMental healthSubstantial health burdenMental health burdenMultivariate logistic regressionMilitary veteransQuality of lifeNon-white veteransTrauma burdenObesity statusHeart diseaseObesity preventionLifestyle characteristicsNicotine dependenceObesityLifestyle variablesLinear regression analysisActive lifestyleTreatment programLogistic regressionAttitudes of U.S. Psychiatry Residents and Fellows towards Mental Illness and its Causes: a Comparison Study with Medical Students
Chiles C, Stefanovics E, Rosenheck R. Attitudes of U.S. Psychiatry Residents and Fellows towards Mental Illness and its Causes: a Comparison Study with Medical Students. Psychiatric Quarterly 2018, 89: 581-588. PMID: 29332234, DOI: 10.1007/s11126-018-9562-y.Peer-Reviewed Original ResearchConceptsMental illnessSupernatural causesFemale genderStudy response ratePsychiatry residentsMedical student surveyBiopsychosocial causesTreatment efficacyResponse rateHealthcare providersIllnessMedical studentsFemale residentsPost-graduate trainingMedical students' attitudesCauseElectronic questionnaireExploratory factor analysisPersonal experienceResidentsFactor analysisSame survey methodsGenderMale counterpartsMedical schools
2017
Correlates of Reduced Violent Behavior Among Patients Receiving Intensive Treatment for Posttraumatic Stress Disorder
Buchanan A, Stefanovics E, Rosenheck RA. Correlates of Reduced Violent Behavior Among Patients Receiving Intensive Treatment for Posttraumatic Stress Disorder. Psychiatric Services 2017, 69: 424-430. PMID: 29241432, DOI: 10.1176/appi.ps.201700253.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderIntensive treatmentStress disorderSubstance useWar-related posttraumatic stress disorderPTSD symptomatologySpectrum of careProgram entryViolent behaviorU.S. military veteransModerate effect sizeClinical factorsPTSD symptom severityShort-term supportObservational studyBaseline levelsPTSD programSymptom severitySpecific causesFour monthsPTSD changeMilitary veteransIncarceration historyEffect sizeTreatmentPsychotropic Medication Prescribing in Iraq/Afghanistan Veterans and Vietnam Era Veterans With Posttraumatic Stress Disorder
Vojvoda D, Stefanovics EA, Rosenheck RA. Psychotropic Medication Prescribing in Iraq/Afghanistan Veterans and Vietnam Era Veterans With Posttraumatic Stress Disorder. The Journal Of Nervous And Mental Disease 2017, 205: 848-854. PMID: 28953506, DOI: 10.1097/nmd.0000000000000755.Peer-Reviewed Original ResearchConceptsIraq/Afghanistan veteransPosttraumatic stress disorderVietnam-era veteransAfghanistan veteransEra veteransAnxiolytics/sedatives/hypnoticsVeterans Health Administration (VHA) administrative dataStress disorderSedative/hypnoticsPsychotropic medication prescribingVeterans Health AdministrationNumber of prescriptionsProportion of veteransIraq/Afghanistan warMedication prescribingPsychotropic medicationsPsychotropic pharmacotherapyFiscal year 2012Psychopharmacological treatmentSame diagnosisHealth AdministrationYounger groupVeteransPrazosinAdministrative dataMinimal Clinically Important Differences (MCID) in Assessing Outcomes of Post-Traumatic Stress Disorder
Stefanovics EA, Rosenheck RA, Jones KM, Huang G, Krystal JH. Minimal Clinically Important Differences (MCID) in Assessing Outcomes of Post-Traumatic Stress Disorder. Psychiatric Quarterly 2017, 89: 141-155. PMID: 28634644, DOI: 10.1007/s11126-017-9522-y.Peer-Reviewed Original ResearchGambling in a National U.S. Veteran Population: Prevalence, Socio-demographics, and Psychiatric Comorbidities
Stefanovics EA, Potenza MN, Pietrzak RH. Gambling in a National U.S. Veteran Population: Prevalence, Socio-demographics, and Psychiatric Comorbidities. Journal Of Gambling Studies 2017, 33: 1099-1120. PMID: 28293767, DOI: 10.1007/s10899-017-9678-2.Peer-Reviewed Original ResearchConceptsTrauma burdenU.S. veteransPsychiatric comorbidityDrug use disordersU.S. veteran populationMental health treatmentMagnitude of associationNon-White HispanicsChi-square testIndependent correlatesDepressive disorderNational HealthRoutine screeningMultinomial logistic regressionPsychiatric disordersGreater prevalenceVeteran populationHealth treatmentVeterans StudyYounger ageOlder ageSquare testLogistic regressionPhysical traumaRecreational gambling
2016
Witchcraft and Biopsychosocial Causes of Mental Illness
Stefanovics EA, He H, Cavalcanti M, Neto H, Ofori-Atta A, Leddy M, Ighodaro A, Rosenheck R. Witchcraft and Biopsychosocial Causes of Mental Illness. The Journal Of Nervous And Mental Disease 2016, 204: 169-174. PMID: 26745309, DOI: 10.1097/nmd.0000000000000422.Peer-Reviewed Original ResearchCorrelates of Improvement in Substance Abuse Among Dually Diagnosed Veterans With Post-Traumatic Stress Disorder in Specialized Intensive VA Treatment
Coker KL, Stefanovics E, Rosenheck R. Correlates of Improvement in Substance Abuse Among Dually Diagnosed Veterans With Post-Traumatic Stress Disorder in Specialized Intensive VA Treatment. Psychological Trauma Theory Research Practice And Policy 2016, 8: 41-48. PMID: 26121176, PMCID: PMC4487392, DOI: 10.1037/tra0000061.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityDiagnosis, Dual (Psychiatry)HumansLinear ModelsMiddle AgedMultivariate AnalysisPsychiatric Status Rating ScalesPsychotropic DrugsStress Disorders, Post-TraumaticSubstance-Related DisordersTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsVeteransViolenceConceptsPost-traumatic stress disorderSubstance abuseEvidence-based substance abuse treatmentStress disorderSevere post-traumatic stress disorderPTSD symptomsProper discharge planningDuration of treatmentCorrelates of improvementAddiction Severity Index AlcoholSubstance use disordersSubstance abuse treatmentEffect sizeDischarge planningPsychiatric medicationsImproved outcomesUse disordersBetter outcomesSynergistic treatment effectSubstance use measuresMultivariate analysisVA treatmentPTSD programAbuse treatmentViolent behavior
2015
Treatment outcomes for veterans with PTSD and substance use: Impact of specific substances and achievement of abstinence
Manhapra A, Stefanovics E, Rosenheck R. Treatment outcomes for veterans with PTSD and substance use: Impact of specific substances and achievement of abstinence. Drug And Alcohol Dependence 2015, 156: 70-77. PMID: 26429726, PMCID: PMC4633308, DOI: 10.1016/j.drugalcdep.2015.08.036.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderAchievement of abstinenceEffect of abstinenceTreatment outcomesSubstance useRates of abstinenceNational program evaluationSubstance abuse groupClinical outcomesBaseline variablesAnalysis of covariancePTSD patientsSpecific substancesMedical problemsPTSD programStress disorderAbstinencePTSD symptomsScant longitudinal dataUse outcomesSelf-reported dataAbuse groupOutcomesSignificant differencesGreater improvementMarijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder.
Wilkinson ST, Stefanovics E, Rosenheck RA. Marijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder. The Journal Of Clinical Psychiatry 2015, 76: 1174-80. PMID: 26455669, PMCID: PMC6258013, DOI: 10.4088/jcp.14m09475.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPTSD symptomsSymptom severityPTSD symptom severityWorse outcomesObservational studyMarijuana useStress disorderAlcohol useRelevant baseline covariatesWorse PTSD symptomsEffect sizeViolent behaviorBaseline characteristicsIntensive treatmentPrevention of useMeasures of alcoholAnalysis of covarianceDrug useAdmissionBaseline covariatesSymptomsTreatment programRelevant covariatesMedical marijuana