Integrated Treatment of Comorbid Depression and Substance Use Disorders
J Clin Psychiatry 2001;62(9):672-677
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: The goals of this 6-month prospective
study were to evaluate the effect of a current diagnosis of
depression on the course and outcome of addiction treatment and
to determine whether patients with depression received or
required additional treatment compared with those without
Method: On entering addiction treatment, 75 men
and 45 women with substance use disorders were assessed by
clinical and semistructured interviews, Global Assessment Scale,
Hamilton Rating Scale for Depression, Beck Depression Inventory,
and revised 90-item Symptom Checklist.
Results: Forty-three patients (35.8%) met DSM-IV
criteria for a current depressive disorder at intake into
addiction treatment. The depressed patients had significantly (p
< .0001) higher levels of psychopathology at intake. However,
contrary to previous studies, they fared as well as the
nondepressed patients in terms of all addiction outcome measures
and all indicators of psychiatric status at 6 months. During the
6-month follow-up period, the depressed patients received more
treatment than the nondepressed patients. Specifically, they had
more psychiatric appointments, and they were more likely to
require inpatient detoxification and to be prescribed new
antidepressant medication regimens.
Conclusion: Depression comorbidity may not have
had a negative impact on the course and outcome of addiction
treatment because the dual disorder was identified at the initial
assessment, and integrated psychiatric care was available. It may
be that additional treatment compensated for greater
psychopathology among dual-disorder patients.