title: Contingency management treatments decrease psychiatric symptoms.
abstract: OBJECTIVE
  Contingency management (CM) is an empirically validated treatment for substance use disorders, but its effects on psychiatric symptoms have not been systematically examined. The purpose of this study was to examine the impact of CM on psychiatric symptoms of cocaine dependent patients receiving CM with standard care versus standard care alone.
  
  
  METHODS
  Psychiatric symptoms were evaluated in 393 patients participating in 1 of 3 randomized trials of CM at treatment initiation and 1, 3 (posttreatment), 6, and 9 months later.
  
  
  RESULTS
  Patients randomized to CM evidenced significant reductions in psychiatric symptoms over time throughout the 9-month follow-up. In contrast, psychiatric symptoms remained stable relative to baseline in patients randomized to standard care. A significant time by treatment condition effect was noted (p < .05) for overall psychiatric distress as well as for specific indices of depression, hostility, interpersonal sensitivity, phobic anxiety and psychoticism symptoms. Reductions in drug use mediated the effects of CM on psychiatric symptoms.
  
  
  CONCLUSIONS
  These data demonstrate that the effects of CM extend beyond their impact on drug use behaviors and the period in which reinforcers are in effect.
authors.affiliation: Department of Medicine.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Petry
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Alessi
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Rash
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008960:Models, Psychological; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D012008:Recurrence; D012054:Reinforcement, Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
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