Psychiatric factors affecting recovery after a long term treatment program for substance use disorder.

ABSTRACT

Psychiatric comorbidity can negatively impact the course of addictions. Psychiatric features of patients who continued treatment after the first stage of an addiction program have not been sufficiently analysed. Therefore, only these patients were included in order to compare psychiatric comorbidity and clinical factors between patients who were able or not to complete a long term substance-free program. Treatment-completion status of 245 patients was systematically recorded. Addiction severity, psychiatry comorbidity, and psychological symptoms were evaluated. No significant differences were found regarding comorbid psychiatric diagnoses and the completion of the treatment. Longer treatment duration (OR 1.22; p < 0.01), higher educational level (OR 2.37; p = 0.02), and cocaine dependence as main substance (OR 3.68; p < 0.01) were found to be related to increased likelihood in completing the treatment. Patients with higher severity of alcohol consumption (OR 0.06; p = 0.02) and more depressive symptoms (OR 0.95; p = 0.01) completed the treatment less frequently. Moreover, differences regarding employment problems, treatment facilities, anxiety symptoms, dysfunctional impulsivity, and mental HRQoL were found. It is concluded that comorbid psychiatric diagnoses do not determine treatment outcomes. However, therapeutic and psychological factors have a major influence on the likelihood to complete a long-term treatment program.