The role of psychiatric disorders in predicting drug dependence treatment outcomes

Wilson M Compton, Linda B Cottler, Jacqueline L Jacobs, Arbi Ben-Abdallah, Edward L Spitznagel
American Journal of Psychiatry 2003, 160 (5): 890-5

OBJECTIVE: Previous research has demonstrated that psychiatric disorders are common among people who abuse alcohol and drugs, but few studies have examined the relationship of psychiatric disorders to drug treatment outcome. The authors conducted such an examination.

METHOD: They successfully reinterviewed 401 drug-dependent subjects (94% of the baseline in-treatment sample) and determined their drug abuse status at follow-up 12 months later.

RESULTS: Analyses indicated that several baseline psychiatric disorders predicted worse outcomes at follow-up. Major depression predicted using a larger number of substances and having more drug dependence diagnoses and symptoms. Alcohol dependence predicted more dependence diagnoses, antisocial personality disorder predicted using a larger number of substances, and generalized anxiety disorder predicted having more dependence diagnoses. Outcomes among men were more closely associated with psychiatric status than outcomes among women, except for phobias, which predicted a better outcome among women.

CONCLUSIONS: These results are unique in their assessment of individuals dependent on illicit substances. Overall, the authors found that women with phobias had better outcomes and that men with psychiatric disorders in general, men with major depression, and men with antisocial personality disorder had worse outcomes.

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