Symptom severity, amount of treatment, and 1-year outcomes among dual diagnosis patients.
This study reports on associations among symptom severity, amount of treatment, and 1-year outcomes in a national sample of 8,622 dual diagnosis patients, who were classified at treatment entry into low-, moderate-, and high-severity groups. Patients with more severe symptoms at intake had poorer 1-year outcomes. Higher severity patients did not receive adequate "doses" of care: Compared with low-severity patients, they had a shorter duration of care, although a longer duration was associated with improved outcomes; they also were less likely to receive outpatient substance abuse treatment, although more intensive treatment was associated with better drug outcomes. High-severity patients improved more on drug and legal outcomes, but less on psychiatric and family/social outcomes, than low-severity patients did when treatment was of longer duration or higher intensity. Dual diagnosis patients with highly severe symptoms would likely benefit from a longer episode of care that includes substance abuse and psychiatric outpatient treatment.
Timko
Christine
C
Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, Menlo Park, California 94025, USA. ctimko@stanford.edu
Moos
Rudolf H
RH
D000704:Analysis of Variance; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000534:rehabilitation*; D008875:Middle Aged; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000145:classification / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome; D014481:United States