Dually diagnosed patients' responses to substance use disorder treatment.
Few studies have investigated whether dually diagnosed patients with co-occurring substance use and psychiatric disorders (DD) respond as well to substance use disorder (SUD) treatments as patients with SUD do. Here we assessed whether male veteran DD and SUD patients with alcohol dependence diagnoses differed in the process and outcomes of residential SUD treatment. The main findings showed that (a) DD patients did not perceive SUD programs as positively as patients with SUD did and had worse proximal outcomes at discharge from treatment; (b) DD patients did as well as SUD patients on 1- and 5-year substance use outcomes but had worse psychiatric outcomes; and (c) patients who perceived treatment more positively and had better outcomes at discharge had better longer term outcomes. Thus, residential SUD programs are relatively effective in reducing DD patients' substance use problems; however, they are less successful in engaging DD patients in treatment and addressing their psychiatric problems.
Boden
M Tyler
MT
Department of Veterans Affairs Health Care System, Center for Health Care Evaluation, Health Services Research and Development Service, Stanford University School of Medicine, Palo Alto, CA, USA. mboden@stanford.edu
Moos
Rudolf
R
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000534:rehabilitation*; D017831:Diagnosis, Dual (Psychiatry); D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D012114:Residential Treatment / Q000379:methods*; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D014728:Veterans; D055815:Young Adult