Prevalence of nonpsychotic mental disorders does not affect treatment outcome in a homeless cocaine-dependent sample

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 behav ioral day treatment and contingency management drug abuse treatment program . Participants were 128 persons: 76.6% male, 23.4% female; 82.2% African-Am erican, 17.2% Caucasian. There were 46 (35.9%) PSUDs and 82 (64.1%) DUAL pa rticipants. Cocaine (96.9%) and alcohol disorders (57.8%) were most prevale nt overall, and 60.2% of participants had two or more psychoactive substanc e use disorders. DUAL participants had significantly more alcohol disorders than PSUDs (62.2% versus 50.0%). The most prevalent mental disorders (othe r than substance use) for the total and DUAL samples were, respectively, mo od (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 th an the PSUD group at baseline in alcohol, medical condition, employment/sup port, 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 an d study limitations related to a retrospective design and select sample of nonpsychotic mental disorders.