title: Predictors of deterioration among patients with substance-use disorders.
abstract: The purpose of this study was to identify patients with substance-use disorders who deteriorate during treatment, and to examine baseline predictors of deterioration. Three groups of 872 patients each, matched on number of problems at baseline, were selected from a larger sample based on their treatment outcome (improved, nonresponsive, deteriorated). Deterioration was predicted by younger age and African-American race; four aspects of patients' history (psychiatric symptoms, arrests, prior drug treatment, and recent inpatient or residential care); and having no close friends. Patients who had both an alcohol and a drug diagnosis, a personality-disorder diagnosis, and those who had a shorter episode of care and fewer outpatient-mental-health visits, also were more likely to deteriorate.
authors.affiliation: Center for Health Care Evaluation. VA Health Care System, Department of Veterans Affairs and Stanford University School of Medicine, Palo Alto, CA 94304, USA. bmoos@stanford.edu
authors.forename: R H
authors.initials: RH
authors.lastname: Moos
authors.forename: B S
authors.initials: BS
authors.lastname: Moos
authors.forename: J W
authors.initials: JW
authors.lastname: Finney
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000367:Age Factors; D003415:Crime; D017831:Diagnosis, Dual (Psychiatry); D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010554:Personality Disorders; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012918:Social Alienation; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology*; D016896:Treatment Outcome