Article

Three-year chemical dependency and mental health treatment outcomes among adolescents: the role of continuing care.

Division of Research, Kaiser Permanente Northern California, Oakland, California 94612-2403, USA.
Alcoholism Clinical and Experimental Research (impact factor: 3.34). 05/2009; 33(8):1417-29. DOI:10.1111/j.1530-0277.2009.00972.x pp.1417-29
Source: PubMed

ABSTRACT Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes.
Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization.
At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively).
A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents.

0 0
 · 
0 Bookmarks
 · 
30 Views
  • Article: [Diagnostic problems in acute epidural hematoma of the posterior cranial fossa].
    U Spieler, J Baltensweiler
    Helvetica chirurgica acta 04/1974; 41(1-2):217-20.
  • Article: Relationship between use of psychiatric services and five-year alcohol and drug treatment outcomes.
    G Thomas Ray, Constance M Weisner, Jennifer R Mertens
    [show abstract] [hide abstract]
    ABSTRACT: The objective of this study was to examine the relationship between use of psychiatric services and alcohol and drug treatment outcomes five years after such treatment. It was anticipated that receipt of psychiatric services would predict long-term abstinence. A sample of 604 outpatients from a managed care organization's chemical dependency program was interviewed about substance use and severity of psychiatric symptoms at baseline and at five years. Patients were required to have at least three years of membership in the health plan during the five years after intake. Severity of psychiatric symptoms was categorized as zero, low, middle, or high. Use of psychiatric services was ascertained on the basis of administrative data from the health plan. Logistic regression analysis was used to assess the relationship between receipt of psychiatric services during the five years after intake and abstinence at five years. Results were adjusted for individual, treatment, and extra-treatment characteristics; severity of psychiatric symptoms at baseline; and other contacts with the health system. Patients who received a threshold level of psychiatric services (an average of at least 2.1 hours a year) were significantly more likely to be abstinent at five years than patients who received less than 2.1 hours a year. The use of psychiatric services among patients with chemical dependency is associated with enhanced long-term outcomes.
    Psychiatric Services 03/2005; 56(2):164-71. · 2.38 Impact Factor
  • Article: Substance dependency treatment for adolescents: practice and research.
    N Jainchill
    [show abstract] [hide abstract]
    ABSTRACT: This paper reviews the more common treatment approaches that address adolescent substance abuse and the spectrum of problems which often attend involvement with drugs. The most common outpatient treatment approaches for adolescents are 12-step based programs and family-based therapies which may be used separately or in conjunction with each other. The therapeutic community is a residential approach, characterized by the use of the peer community itself to facilitate social and psychological change in individuals. Both outpatient and residential modalities have demonstrated effectiveness in working with adolescents. Ideally, the type of intervention will depend upon the young person's needs, in particular the extent and effects of his/her drug use, as well as the level of other problems. Overall, treatment must address a range of concerns of special relevance to adolescents because of their age and dependency status; for example, developmental stage, cultural issues, and gender issues.
    Substance Use &amp Misuse 35(12-14):2031-60. · 1.10 Impact Factor

Show more

Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

12-step participation
 
3-year CD
 
4 CD programs
 
Abstinence
 
CD treatment episode
 
continuing care model
 
good 1-year CD outcomes
 
health system
 
index CD
 
long-term outcomes
 
lower Internalizing
 
mental health
 
MH outcomes
 
MH outcomes 3 years
 
ongoing CD
 
psychiatric treatment episodes
 
services [chemical dependency
 
study examines
 
third follow-up years
 
total abstinence