Substance Abuse

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Impact of Psychiatric Disorders on Treatment Outcomes for Patients with Substance Abuse

Daniel Painter

Raritan Valley Community College

Table of Contents

Introduction………………………………………………………………………..page 3

Abstract 1………………………………………………………………………….page 4-5

Critique 1………………………………………………………………………….page 5

Abstract 2…………………………………………………………………………page 6

Critique 2………………………………………………………………………….page 6-7

Abstract 3…………………………………………………………………………page 8

Critique 3………………………………………………………………………….page 8

Conclusion………………………………………………………………………..page 9

Introduction

For this research I selected the articles that concentrated on treatment outcomes for clients with addictions who also had a mental illness diagnoses (depression, anxiety, antisocial personality disorder, phobias). The first two research studies were conducted at different times but by the same researcher, Drar Charney, MD, and concentrate on outcomes of addiction treatment in patients with co-occurring disorders of anxiety and depression, or both at the same time. The last article by Wilson Compton, MD, focuses on drug dependence treatment outcomes in patient with a variety of mental illnesses. All three studies show similar results in predicting outcomes.

Study #1 Abstract

The first study that I selected, “Association Between Concurrent Depression And Anxiety And Six Month Outcome Of Addiction Treatment” conducted by Dara Charney, MD, et al, focuses the common problem of depressive or anxiety symptoms appearing together with drug abuse. The study was conducted for 6 months, used a sample of 326 patients that were assessed through semi structured interviews, ASI, BDI, and Symptom Checklist 90 and then reassessed after 6 months. The objectives of the study were to assess rates of depression and anxiety in patients seeking addiction treatment and examine how the existence of concurrent psychiatric symptoms will influence treatment outcomes. The sample included 326 patients which was mixed population of adults with substance abuse disorder, who were predominantly white (93%) and male (64%) with a mean age of 41 years old. The sample included patients who were recruited upon entering treatment at the MUHC addictions unit. All patients were eligible for study – there were no exclusion criteria. 63% of patients had significant psychiatric symptoms at intake: 15% had depressive symptoms, 16% had anxiety symptoms and 32% presented with combined depressive and anxiety symptoms. During the six-month follow-up study, participants were offered standard treatment: outpatient detoxification, one or two 90-minute group therapy sessions per week, at least four 50-minute individual therapy sessions and random urine drug screens throughout treatment. Follow up included even those participants who dropped out of the treatment (154 patients dropped out of treatment before 6 months mark) and all participants were asked about the outcome of treatment (abstinence status and duration of continuous abstinence), psychological distress and depressive symptoms. Results of the study revealed that those patients who were presented with few psychiatric symptoms on intake or presented with either depressive or anxiety symptoms on intake fared better than those who presented with depressive and anxiety symptoms together: 73% were still abstinent at 6 months.

Critique of study #1

The study supported studied done earlier on the same subject and came up with similar results: patients with co-occurring depressive, anxiety symptoms and addictions fare worse at the end of the addiction treatment than those who do not present with co-occurring symptoms. There are several drawbacks in the means this study employed. The sample was not representative of the community at large, because the majority of the participants were white males. It was not a random sample as well, because patients were recruited at the same facility....
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