Psychiatric Care of Patients With Depression and Comorbid Substance Use Disorders.
J Clin Psychiatry 2000;61(9):698-705
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The goal of this study was to
describe the sociodemographic and clinical characteristics and
routine psychiatric care of depressed patients with or without
substance use disorders (SUDs) and to assess the association
between the presence of comorbid SUD and the psychiatric
management of patients with depression.
Method: Each of a sample of 531 psychiatrists
participating in the Practice Research Network (PRN) of the
American Psychiatric Institute for Research and Education was
asked to provide information about 3 randomly chosen patients.
Data were collected using a self-administered questionnaire,
which generated detailed diagnostic and clinical data on 1228
psychiatric patients. Weighted data were analyzed using the
SUDAAN software package. Multivariate logistic regression was
used to compare depressed patients with and without SUD.
Results: A total of 595 patients (48.4%) were
diagnosed with depression (DSM-IV criteria). The prevalence of
SUD (excluding nicotine dependence) in this group was 18.1%. The
group with SUD had a significantly larger proportion of males,
young adults, patients seen in public general hospitals, and
non-managed care public plans. No significant group differences
were found for primary payer, locus of care, length of treatment,
type of current or past treatment, and prescription of
medications. Only 2.2% of SUD patients were prescribed with an
anti-SUD medication (i.e., disulfiram and naltrexone).
Conclusion: Concomitant SUDs have little effect
on the routine psychiatric care of depressed patients. Efforts
should be made to improve the identification and management of
depressed patients with SUD.