Recent suicide attempt and the effectiveness of inpatient and outpatient substance use disorder treatment.
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.
Ilgen
Mark A
MA
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
Tiet
Quyen
Q
Finney
John W
JW
Harris
Alex H S
AH
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*