Predictors of completing treatment and achieving abstinence during inpatient dual diagnosis treatment

Abstract

Background: Little is known about predictors of successful inpatient treatment of dual diagnosis patients.

Methods: In a naturalistic prospective study, consecutive patients admitted to a dual diagnosis inpatient cognitive milieu therapy program were evaluated at intake to treatment with the Brief Psychiatric Rating Scale (BPRS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Severity of Dependence Scale (SDS). Logistic regression was used to determine predictors of confirmed abstinence during community linkage and completing treatment with medical advice.

Results: No significant predictors were found of completing treatment. High thought disturbance, anxiety and severity of dependence were associated with drug or alcohol use during community linkage. A diagnosis of alcohol dependence was associated with abstinence during community linkage.

Discussion: Dual diagnosis patients with severe substance dependence, as well as patients with elevated thought disturbance and anxiety, represent a challenge in a milieu therapeutic setting. Implications for treatment for patients with these complex problems will be addressed in the discussion.

Keywords:

• abstinence
• anxiety
• depression
• inpatient treatment
• outcome predictors
• psychosis

Acknowledgements

This research was supported by the Ministry of the Interior and Health Psychiatry Support Pool. The Scientific Ethical Committees at Copenhagen and Frederiksberg Municipalities evaluated the protocol and approved the study, Project # (KF) 01-017/03.