title: Impact of psychiatric comorbidity on the in-treatment outcomes of cocaine-dependent patients in therapeutic communities.
abstract: BACKGROUND
  This study aimed to explore the association between psychiatric comorbidity and treatment outcomes in therapeutic communities (TCs).
  
  
  METHODS
  A prospective longitudinal descriptive design was used. A baseline psychopathological assessment was performed within the first 15 to 20 days of treatment in the TCs. The length of treatment stay was computed for each individual. The study was conducted in the region of Andalusia (Spain). The participants were 218 cocaine-dependent individuals. Psychopathological assessment was performed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). The outcome measures were retention, defined as the time in TC treatment (number of days), and the patient's assessment upon leaving the TC.
  
  
  RESULTS
  The number of psychopathological comorbidities present in the last year among the patients was high (57.8%) and was associated with a worse response to treatment (P =.004). The patients with co-occurring psychiatric disorders had a decreased probability of remaining in the TCs compared with patients who only presented with substance use disorders (hazards ratio = 1.61).
  
  
  CONCLUSIONS
  Psychiatric comorbidity predicts cocaine-dependent individuals' likelihood of remaining in residential treatment.
authors.affiliation: a Community Mental Health Unit of Villamartín, Mental Health Hospital , Cádiz , Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: González-Saiz
authors.forename: Esperanza
authors.initials: E
authors.lastname: Vergara-Moragues
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
authors.forename: Fermín
authors.initials: F
authors.lastname: Fernández-Calderón
authors.forename: Oscar M
authors.initials: OM
authors.lastname: Lozano
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D013808:Therapeutic Community; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cocaine; psychiatric comorbidity; retention; substance abuse; therapeutic community