Disparities in program enrollment and employment outcomes for veterans with psychiatric and co-occurring substance use disorders referred or enrolled for VHA vocational rehabilitation

"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), is the most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers. DSM-5-TR includes fully revised text and references, updated diagnostic criteria and ICD-10-CM codes since DSM-5 was published in 2013. It features a new disorder, prolonged grief disorder, as well as codes for suicidal behavior available to all clinicians of any discipline without the requirement of any other diagnosis. With contributions from over 200 subject matter experts, this updated volume boasts the most current text updates based on the scientific literature. Now in four-color and with the ability to authenticate each printed copy, DSM-5-TR provides a cohesive, updated presentation of criteria, diagnostic codes, and text. This latest volume offers a common language for clinicians involved in the diagnosis and study of mental disorders and facilitates an objective assessment of symptom presentations across a variety of clinical settings-inpatient, outpatient, partial hospital, consultation-liaison, clinical, private practice, and primary care. Important updates in DSM-5-TR include 1) fully revised text for each disorder with updated sections on associated features, prevalence, development and course, risk and prognostic factors, culture, diagnostic markers, suicide, differential diagnosis, and more; 2) addition of prolonged grief disorder (PGD) to Section II; 3) over 70 modified criteria sets with helpful clarifications since publication of DSM-5; 4) fully updated Introduction and Use of the Manual to guide usage and provide context for important terminology; 5) considerations of the impact of racism and discrimination on mental disorders integrated into the text; 6) new codes to flag and monitor suicidal behavior, available to all clinicians of any discipline and without the requirement of any other diagnosis; 7) fully updated ICD-10-CM codes implemented since 2013, including over 50 coding updates new to DSM-5-TR for substance intoxication and withdrawal and other disorders"--

Substance use disorders (SUDs) are a significant problem among our nation’s military veterans. In the following overview, we provide information on the prevalence of SUDs among military veterans, clinical characteristics of SUDs, options for screening and evidence-based treatment, as well as relevant treatment challenges. Among psychotherapeutic approaches, behavioral interventions for the management of SUDs typically involve short-term, cognitive-behavioral therapy interventions. These interventions focus on the identification and modification of maladaptive thoughts and behaviors associated with increased craving, use, or relapse to substances. Additionally, client-centered motivational interviewing approaches focus on increasing motivation to engage in treatment and reduce substance use. A variety of pharmacotherapies have received some support in the management of SUDs, primarily to help with the reduction of craving or withdrawal symptoms. Currently approved medications as well as treatment challenges are discussed.

This review synthesized prospective evidence to assess whether achieving employment alters the course of schizophrenia-spectrum disorder.