title: Three-year outcomes of long-term patients with co-occurring bipolar and substance use disorders.
abstract: Little is known about the long-term outcomes of patients in the public mental health system who are disabled by co-occurring bipolar and substance use disorders. This article reports on the 3-year course of 51 patients with co-occurring bipolar and substance use disorders in the New Hampshire Dual Diagnosis Study. Participants received integrated dual disorders treatments in the state mental health system and were independently assessed with standardized measures at baseline and every 6 months for 3 years. Though psychiatric symptoms improved only modestly, participants improved steadily in terms of remission from substance abuse (61% in full remission at 3 years); they also achieved greater independent living (average 239 days in third year), competitive employment (49% in third year), regular social contacts with nonsubstance abusers (46% at 3 years), and quality of life (56% satisfied with life at 3 years). Different domains of outcome were only weakly related to each other. Long-term, disabled patients with co-occurring bipolar and substance use disorders have potential for remission from substance abuse and substantial improvements in functioning and quality of life.
authors.affiliation: Department of Psychiatry and Community, Dartmouth Medical School, Lebanon, New Hampshire 03766, USA. Robert.E.Drake@Dartmouth.edu
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drake
authors.forename: Haiyi
authors.initials: H
authors.lastname: Xie
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: McHugo
authors.forename: Martha
authors.initials: M
authors.lastname: Shumway
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000534:rehabilitation*; D003156:Community Mental Health Services; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009513:New Hampshire; D009790:Occupations; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012919:Social Behavior; D019966:Substance-Related Disorders / Q000150:complications* / Q000534:rehabilitation*; D016896:Treatment Outcome