A comparative evaluation of substance abuse treatment - IV. The effect of comorbid psychiatric diagnoses on amount of treatment, continuing care, and1-year outcomes

Recent surveys of the substance abuse patient population have shown a strik ing increase in the proportion of patients with a comorbid psychiatric diso rder. In this study, patients with substance abuse and psychotic, anxiety/d epressive, or personality disorders were compared with patients with only s ubstance use disorders on treatment experiences and outcomes. Regardless of dual diagnosis status, patients generally improved on both substance use a nd social functioning outcomes after substance abuse treatment. At the 1-ye ar follow-up, dually diagnosed patients, and patients with only substance u se disorders, had comparable substance use outcomes. However, patients with major psychiatric disorders, specifically psychotic and anxiety/depressive disorders, fared worse on psychological symptoms and employment outcomes t han did patients with personality disorders and only substance use disorder s. Although there were some group differences on the amount of index treatm ent received and continuing care, the overall pattern of relationships betw een treatment variables and outcomes was comparable for the patient groups. In addition, there was no diagnostic group by treatment orientation matchi ng effects, which indicated that the dual diagnosis patient groups improved as much in 12-Step as in cognitive-behavioral substance abuse programs.