Self-reported depression as a predictor of dropout in a hierarchical therapeutic community.
Studies of the importance of depression for treatment outcome in hierarchical therapeutic communities are scarce. Therefore, a total of 144 substance abusers consecutively entering Phoenix House in Oslo were followed prospectively through an entire 18-month program. Using a structured interview and two self-report instruments, Million Clinical Multiaxial Inventory and Symptom Checklist-90, 69% of the clients were depressive cases at the time of application. However, depression alone did not predict dropout during the following 1-year inpatient phase. Of the 36 clients who completed the drug-free inpatient year, 19% were depressive cases at this point. Thus being depressed after 1 year increased the risk for dropout five times compared to being nondepressed. The study demonstrates the need for a modification of the treatment model, which might include the use of antidepressant and/or individual psychotherapy, at least in the outpatient phase.
Ravndal
E
E
Department of Behavioural Sciences in Medicine, University of Oslo, Norway.
Vaglum
P
P
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009664:Norway; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation; D010352:Patient Dropouts / Q000523:psychology*; D010552:Personality Assessment; D010555:Personality Inventory; D015813:Substance Abuse Detection; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D013808:Therapeutic Community; D016896:Treatment Outcome