title: Depressive Symptoms and Associated Clinical Characteristics in Outpatients Seeking Community-Based Treatment for Alcohol and Drug Problems.
abstract: BACKGROUND
  Comorbid psychiatric and substance use disorders are common and associated with poorer treatment engagement, retention, and outcomes. This study examines the presence of depressive symptoms and the demographic and clinical correlates in a diverse sample of substance abuse treatment seekers to better characterize patients with co-occurring depressive symptoms and substance use disorders and understand potential treatment needs.
  
  
  METHODS
  Baseline data from a randomized clinical effectiveness trial of a computer-assisted, Web-delivered psychosocial intervention were analyzed. Participants (N = 507) were recruited from 10 geographically diverse outpatient drug treatment programs. Assessments included the self-report Patient Health Questionnaire, and measures of coping strategies, social functioning, physical health status, and substance use.
  
  
  RESULTS
  One fifth (21%; n = 106) of the sample screened positive for depression; those screening positive for depression were significantly more likely to screen positive for anxiety (66.9%) and posttraumatic stress disorder (PTSD; 42.9%). After controlling for anxiety and PTSD symptoms, presence of depressive symptoms remained significantly associated with fewer coping strategies (P = .001), greater impairment in social adjustment (P < .001), and poorer health status (P < .001), but not to days of drug use in the last 90 days (P = .14).
  
  
  CONCLUSIONS
  Depression is a clinically significant problem among substance abusers, and, in this study, patients who screened positive for depression were more likely to have co-occurring symptoms of anxiety and PTSD. Additionally, the presence of depressive symptoms was associated with fewer coping strategies and poorer social adjustment. Coping skills are a significant predictor of addiction outcomes, and it may be especially important to screen for and enhance coping among depressed patients. Evidence-based interventions that target coping skills and global functioning among substance abusers with depressive symptoms may be important adjuncts to usual treatment.
authors.affiliation: a School of Social Work , The University of Texas at Arlington , Arlington , Texas , USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Sanchez
authors.forename: Robrina
authors.initials: R
authors.lastname: Walker
authors.forename: Aimee N C
authors.initials: AN
authors.lastname: Campbell
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Greer
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Hu
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Grannemann
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D017831:Diagnosis, Dual (Psychiatry) / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: Depression; addiction outcomes; coping strategies; substance use
references.citation: J Consult Clin Psychol. 2003 Feb;71(1):118-28
references.pmid: 12602432
references.citation: Curr Opin Psychiatry. 2012 May;25(3):165-71
references.pmid: 22449770
references.citation: J Subst Abuse Treat. 2009 Oct;37(3):318-25
references.pmid: 19359127
references.citation: JAMA. 1999 Nov 10;282(18):1737-44
references.pmid: 10568646
references.citation: Soc Work Public Health. 2013;28(3-4):407-23
references.pmid: 23731428
references.citation: J Clin Psychiatry. 2006 Feb;67(2):247-57
references.pmid: 16566620
references.citation: Curr Psychiatry Rep. 2006 Oct;8(5):363-70
references.pmid: 16968616
references.citation: Arch Gen Psychiatry. 1984 Dec;41(12):1178-82
references.pmid: 6334503
references.citation: JAMA. 1994 Dec 14;272(22):1749-56
references.pmid: 7966923
references.citation: Addict Behav. 2008 Feb;33(2):381-7
references.pmid: 17964079
references.citation: Addict Behav. 2007 Feb;32(2):384-91
references.pmid: 16797139
references.citation: Br J Psychiatry Suppl. 1996 Jun;(30):17-30
references.pmid: 8864145
references.citation: J Subst Abuse Treat. 2010 Jun;38 Suppl 1:S61-9
references.pmid: 20307797
references.citation: Psychol Addict Behav. 2009 Jun;23(2):226-37
references.pmid: 19586139
references.citation: Health Policy. 1990 Dec;16(3):199-208
references.pmid: 10109801
references.citation: Arch Gen Psychiatry. 2007 Jul;64(7):830-42
references.pmid: 17606817
references.citation: J Clin Psychol. 2003 Apr;59(4):423-37
references.pmid: 12652635
references.citation: Drug Alcohol Depend. 2013 Feb 1;128(1-2):8-14
references.pmid: 22898437
references.citation: Depress Anxiety. 2012 Feb;29(2):111-22
references.pmid: 22495941
references.citation: JAMA. 2004 Apr 21;291(15):1887-96
references.pmid: 15100209
references.citation: J Subst Abuse Treat. 2014 Jan;46(1):60-5
references.pmid: 23954392
references.citation: Drug Alcohol Depend. 2009 Jan 1;99(1-3):248-60
references.pmid: 18986774
references.citation: Arch Gen Psychiatry. 2007 May;64(5):566-76
references.pmid: 17485608
references.citation: Depress Anxiety. 2008;25(4):274-81
references.pmid: 18415950
references.citation: Addict Behav. 2012 Apr;37(4):427-34
references.pmid: 22197045
references.citation: J Pers. 2005 Dec;73(6):1633-56
references.pmid: 16274448
references.citation: Exp Clin Psychopharmacol. 2008 Apr;16(2):132-43
references.pmid: 18489017
references.citation: J Behav Med. 1987 Feb;10(1):1-18
references.pmid: 3585998
references.citation: Arch Gen Psychiatry. 2005 Oct;62(10):1148-56
references.pmid: 16203960
references.citation: Contemp Clin Trials. 2012 Mar;33(2):386-95
references.pmid: 22085803
references.citation: Am J Psychiatry. 2003 May;160(5):890-5
references.pmid: 12727692
references.citation: J Nerv Ment Dis. 1978 May;166(5):317-26
references.pmid: 650195
references.citation: Am J Addict. 2011 Sep-Oct;20(5):441-6
references.pmid: 21838843
references.citation: J Gen Intern Med. 2001 Sep;16(9):606-13
references.pmid: 11556941
references.citation: Depress Anxiety. 2012 Jun;29(6):471-8
references.pmid: 22553107
references.citation: J Subst Abuse. 1995;7(4):481-97
references.pmid: 8838629
references.citation: JAMA. 2003 Jun 18;289(23):3095-105
references.pmid: 12813115