Persistence of impaired functioning and psychological distress after medical hospitalization for men with co-occurring psychiatric and substance use disorders

Quality of life among treatment seeking methamphetamine-dependent individuals

As the number of men and women entering treatment for substance use disorders continues to increase across the country, it becomes vitally important to understand their quality of life (QOL) or perceived health status, in order to inform treatment efforts for improving such outcomes. To date, QOL assessments among methamphetamine (MA) dependent users are limited. This paper examines QOL health status among a sample of 838 treatment seeking MA users at admission. Using regression analysis, predictors of QOL are examined among MA users. Predictors of poor QOL among MA users at treatment admission included being female, white, high school educated or more, married, experiencing psychosocial dysfunction (lifetime trauma, suicide, social conflict), reporting a high frequency of both MA and polydrugs for 15 days or more in the past month, chronicity of MA and polydrug use, injection use, and having co-morbid medical and psychiatric impairment. Employment status was the only factor related to better health status perceptions. This study expands the scope of scholarly examination of MA-dependent users entering treatment, as there has not been a development of coherent profiles of QOL among representative samples of clinical MA-abusing populations to date.

Substance use, depression, and mental health functioning in patients seeking acute medical care in an inner-city ED

The study investigated the behavioral health of a consecutive sample of 5,641 adult emergency department (ED) patients aged 19 through 60 presenting for medical care in a large, inner-city hospital ED. Twenty-three percent met the criteria for major depression; average mental health functioning, as measured by the mental health component of the SF-12, was half of a standard deviation lower than in the general population; 15% met the criteria for alcohol or drug abuse/dependence in the past year. Comorbidity was high. These behavioral health disorders may complicate treatment and diagnosis of the chief presenting complaint. These findings, coupled with the high rates of these disorders, suggest the importance of screening and either beginning appropriate treatment or offering appropriate referral for such disorders in ED settings.

Predictors of follow-up health status in the Drug Abuse Treatment Outcome Study (DATOS)

This study examined the predictors of self-reported health status at follow-up in the Drug Abuse Treatment Outcomes Study (DATOS), a longitudinal study of drug abuse treatment programs and patients in 1991-1993. Baseline and follow-up interviews of 2966 patients in 75 programs were performed. The follow-up assessment was targeted to occur 12 months after treatment terminated; long-term methadone patients in treatment for the entire 12-month period were interviewed 24 months after intake. A composite measure, developed through principal component analysis, assessed health status. A multivariate hierarchical linear regression model adjusted for identified independent baseline predictors of health status at follow-up. Poor physical health status (including the composite measure, comorbid conditions and pain) and greater severity of psychiatric symptoms at baseline were the strongest predictors of poor health status at follow-up. Other predictors of worse health status included older age, public insurance coverage and unemployment. We conclude that baseline health status and psychiatric symptoms predict the subsequent health status of patients in substance abuse treatment patients as in other clinical populations. Future research should examine whether early identification and treatment of physical and mental health problems among patients in addiction treatment programs might remediate their adverse effects on long-term health status outcomes.