Substance Abuse 2015;36(3):297-303. [doi: 10.1080/08897077.2014.937845]
Katherine Sanchez, PhD, MSSW (University of Texas at Arlington, TX Node), N. Robrina Walker, PhD (University of Texas Southwest Medical Center, TX Node) Aimee N. C. Campbell, PhD, MSW (Columbia University, GNY Node), Tracy L. Greer, PhD (University of Texas Southwest Medical Center, TX Node), Mei-Chen Hu, PhD (Columbia University, GNY Node), Bruce D. Grannemann, MS (University of Texas Southwest Medical Center, TX Node), Edward V. Nunes, MD (Columbia University, GNY Node), Madhukar H. Trivedi, MD (University of Texas Southwest Medical Center, TX Node).
Comorbid psychiatric and substance use disorders are common and associated with poorer treatment engagement, retention, and outcomes. This study examines the presence of depressive symptoms and demographic and clinical correlates in a diverse sample of substance abuse treatment-seekers to better characterize patients with co-occurring depressive symptoms and substance use disorders and understand potential treatment needs. Baseline data from a randomized clinical effectiveness trial of a computer-assisted, web-delivered psychosocial intervention were analyzed (CTN-0044, Web Delivery of Evidence-Based, Psychosocial Treatment for Substance Use Disorders). Participants (N=507) were recruited from 10 geographically diverse outpatient drug treatment programs. Assessments included the self-report Patient Health Questionnaire, and measures of coping strategies, social functioning, physical health status, and substance use.
One-fifth (21%; n=106) of the sample screened positive for depression; those screening positive for depression were significantly more likely to screen positive for anxiety (66.9%) and PTSD (42.9%). After controlling for anxiety and PTSD symptoms, presence of depressive symptoms remained significantly associated with fewer coping strategies (p=.001), greater impairment in social adjustment (p<.001), and poorer health status (p<.001), but not to days of drug use in the last 90 days (p=.14).
Conclusions: Depression is a clinically significant problem among substance abusers and, in this study, patients who screened positive for depression were more likely to have co-occurring symptoms of anxiety and PTSD. Additionally, the presence of depressive symptoms was associated with fewer coping strategies and poorer social adjustment. Coping skills are a significant predictor of addiction outcomes and it may be especially important to screen for and enhance coping among depressed patients. Evidence-based interventions that target coping skills and global functioning among substance abusers with depressive symptoms may be important adjuncts to usual treatment. Understanding the factors that might affect outcomes is important for the planning and implementation of substance abuse treatment. (Article (Peer-Reviewed), PDF, English, 2015)
Keywords: Anxiety disorders | Co-occurring disorders | Coping skills | Depression | Post-traumatic stress disorder (PTSD) | Substance Abuse (journal)
Document No: 1154, PMID: 25456093, PMCID: PMC4313559.
Submitted by Jack Blaine, NIDA.