Prevalence of nonpsychotic mental disorders does not affect treatment outcome in a homeless cocaine-dependent sample
Prevalence of nonpsychotic mental disorders does not affect treatment outcome in a homeless cocaine-dependent sample
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DOI：
10.1081/ada-100103120
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发表时间：
2001-01-01
影响因子：
2.7
通讯作者：
Usdan, S
中科院分区：
文献类型：
--
作者：
McNamara, C;Schumacher, JE;Usdan, S
本研究介绍了在一个无家可归的人参与行为日治疗和应急管理药物滥用治疗计划的人口中，双重诊断（精神活性物质使用障碍[PSUD]加上其他非精神病性精神障碍）的患病率和治疗结果。参与者为128人：76.6%为男性，23.4%为女性; 82.2%为非洲裔美国人，17.2%为白人。有46名（35.9%）PSUD参与者和82名（64.1%）DUAL参与者。酗酒（96.9%）和酒精障碍（57.8%）是最普遍的整体，60.2%的参与者有两个或两个以上的精神活性物质使用障碍。DUAL参与者的酒精障碍明显多于PSUD（62.2%对50.0%）。总样本和DUAL样本中最常见的精神障碍（除物质使用外）分别为情绪（51.6%和80.5%）和焦虑（35.9%和56.1%），31.3%和48.8%有两种以上的精神障碍。在基线时，DUAL组在酒精、医疗状况、就业/支持和精神状态方面的ASI比PSUD组有更严重的问题。两组在6个月随访时均显示治疗改善，DUAL组在7个ASI区域中的5个区域的平均变化大于PSUD组。这些研究结果进行了讨论的双重诊断的治疗效果和研究的局限性有关的回顾性设计和选择样本的非精神病性精神障碍。
This study presents the prevalence and treatment outcome of DUAL diagnoses (psychoactive substance use disorders [PSUD] plus other nonpsychotic mental disorders) among a population of homeless persons participating in a behavioral day treatment and contingency management drug abuse treatment program. Participants were 128 persons: 76.6% male, 23.4% female; 82.2% African-American, 17.2% Caucasian. There were 46 (35.9%) PSUDs and 82 (64.1%) DUAL participants. Cocaine (96.9%) and alcohol disorders (57.8%) were most prevalent overall, and 60.2% of participants had two or more psychoactive substance use disorders. DUAL participants had significantly more alcohol disorders than PSUDs (62.2% versus 50.0%). The most prevalent mental disorders (other than substance use) for the total and DUAL samples were, respectively, mood (51.6% and 80.5%) and anxiety (35.9% and 56.1%), and 31.3% and 48.8% had more than two mental disorders. The DUAL group had more severe problems than the PSUD group at baseline in alcohol, medical condition, employment/support, and psychiatric status areas on the ASI. Both groups showed treatment improvements at 6-months followup with the DUAL group showing greater mean changes than the PSUD group in five of the seven ASI areas. These findings are discussed in terms of effect of dual diagnoses on treatment outcome and study limitations related to a retrospective design and select sample of nonpsychotic mental disorders.