Psychiatric comorbidity, continuing care and mutual help as predictors of five-year remission from substance use disorders.
OBJECTIVE
In a cohort of 2,595 male patients in VA intensive treatment programs for substance use disorders (SUD), we tested whether psychiatric comorbidity, outpatient care and mutual help group attendance during the first two follow-up years predicted remission status at Year 5, controlling for covariates.


METHODS
Logistic regression modeling of longitudinal data was used to test the hypotheses.


RESULTS
Dual diagnosis patients were less likely to be in remission at Year 5 than SUD-only patients. Outpatient care was at best only weakly related to Year 5 remission status. By contrast, mutual help involvement substantially improved the chances of substance use remission at Year 5 for both SUD-only and dual diagnosis patients. Mutual help involvement did not, however, offset the poorer prognosis for dual diagnosis patients.


CONCLUSIONS
Because mutual help groups specifically targeted to individuals with comorbid substance use and psychiatric disorders are currently rare, further research is recommended to investigate whether they are more effective than standard SUD mutual help groups in facilitating the recovery of persons with dual diagnoses.
Ritsher
Jennifer Boyd
JB
Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, & Stanford University School of Medicine, Palo Alto, California, USA. jennifer.ritsher@med.va.gov
McKellar
John D
JD
Finney
John W
JW
Otilingam
Poorni G
PG
Moos
Rudolf H
RH
D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity / Q000639:trends; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology / Q000706:statistics & numerical data / Q000639:trends; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000523:psychology / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D012657:Self-Help Groups / Q000706:statistics & numerical data* / Q000639:trends; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*