Predicting Response to Alcohol and Drug Abuse Treatments

TLDR

The authors followed 460 male alcoholics and 282 drug addicts at six‑month follow‑up after treatment in six rehabilitation programs and then stratified participants by psychiatric severity at admission to examine treatment outcomes. Overall improvement was observed, but only patients with low psychiatric severity improved in every program, high‑severity patients showed virtually no improvement, and mid‑range severity patients (60 % of the sample) exhibited differential outcomes depending on treatment type and patient‑program matching, underscoring treatment specificity and the influence of psychiatric factors. Published in Arch Gen Psychiatry 1983;40:620‑625.

Abstract

• Male alcoholics (n=460) and drug addicts (n=282) were evaluated at six-month follow-up after treatment in six rehabilitation programs. Initial analyses of the unstratified samples showed significant patient improvement, but no evidence of differential effectiveness from different treatments or from "matching" patients to treatments. The two samples were then divided into groups based on the number, duration, and intensity of their psychiatric symptoms at admission, ie, their overall "psychiatric severity." Patients with low psychiatric severity improved in every treatment program. Patients with high psychiatric severity showed virtually no improvement in any treatment. Patients with midrange psychiatric severity (60% of the samples) showed outcome differences from different treatments and especially from specific patient-program matches. These findings support the effectiveness and specificity of different substance abuse treatments, suggest methodologic reasons for the lack of similar findings in previous studies, and demonstrate the importance of psychiatric factors in substance abuse treatment. (<i>Arch Gen Psychiatry</i>1983;40:620-625)