PREDICTION OF COMPLIANCE WITH OUTPATIENT REFERRAL IN PATIENTS WITH SCHIZOPHRENIA AND PSYCHOACTIVE SUBSTANCE USE DISORDERS

Background: Most patients with concurrent schizophrenia and psychoacti ve substance use disorders may be adequately treated as outpatients. H owever, many do not comply with outpatient referrals and are therefore at heightened risk for rehospitalization. Method: Drawing on standard ized interview data collected during an index hospitalization, we deve loped a logistic regression model to predict compliance with outpatien t treatment. The model was tested on a confirmatory sample, and its se nsitivity and specificity were further evaluated in a cross-validation study of 1000 random samples. Results: In a reference sample, the log istic function distinguished compliant from noncompliant patients in 3 7 (76%) of 49 cases. In a confirmatory sample, compliance status was p redicted for 11 (78%) of 14 patients with a sensitivity of 1.00 and a specificity of 0.67. Women and patients with negative syndrome schizop hrenia were compliant with outpatient referral, whereas those with mix ed syndromes were most likely to be noncompliant. Cross-validation sup ports the stability of the model. Conclusion: While most persons with schizophrenia and concurrent substance abuse comply with integrated ou tpatient treatment, most who cannot may be predicted in advance.