title: Recent suicide attempt and the effectiveness of inpatient and outpatient substance use disorder treatment.
abstract: BACKGROUND
  The present study investigated whether or not the effect of treatment setting (inpatient or outpatient) on 6-mo follow-up substance use varied for suicidal and non-suicidal patients. In particular, the study tested the hypothesis that treatment setting would have no differing effect for non-suicidal participants, but for suicidal participants, inpatient setting would be more closely associated with positive outcomes than the outpatient setting.
  
  
  METHODS
  A national sample of patients presenting for treatment of substance use disorders in the Veterans Administration health care system was selected to participate in the study. A total of 1,289 participants provided complete data on psychiatric and substance-related problems at baseline and 6-mo follow-up.
  
  
  RESULTS
  At baseline, 4% (n=53) of the sample reported having made a suicide attempt within the past 30 days. Those who reported a suicide attempt were no more likely to have been treated in an inpatient setting than in an outpatient setting. A significant interaction between baseline suicide attempt and treatment setting was found, such that non-suicidal patients reported similar patterns of substance use when treated in inpatient or outpatient settings, but suicidal patients were significantly more likely to have better substance-related outcomes at 6-mo follow-up if they were treated in inpatient compared with outpatient settings.
  
  
  CONCLUSIONS
  Suicidal patients displayed substantial improvement after substance use disorders treatment and seem particularly responsive to treatment in inpatient settings.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025, USA. Mark.Ilgen@med.va.gov
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: Quyen
authors.initials: Q
authors.lastname: Tiet
authors.forename: John W
authors.initials: JW
authors.lastname: Finney
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D013406:Suicide, Attempted / Q000523:psychology*