Prevalence of Co-Occurring Conditions Study

findings indicate that 92% of patients discharged from AdCare Hospital over a one-year period had co-occurring medical and/or psychiatric disorders. Fifty-four percent of patients discharged from AdCare Hospital had combined psychiatric disorders (such as mood and anxiety disorders) and chronic medical conditions (such as diabetes, liver-related disorders and chronic pulmonary disorders); 29% had psychiatric disorders only; and 9% had medical conditions only. Only 8% of the patients had no co-occurring medical and/or psychiatric disorder.

Patient Treatment Feedback Survey (PFS)

was administered at AdCare’s six outpatient clinics in May of 2007. Five hundred surveys were completed by patients participating in various levels of group treatment and individual counseling. Most respondents reported being very satisfied with outpatient treatment. As would be expected, higher PFS scores were reported by respondents who were in treatment for longer periods of time, and by those who did not report any substance use or cravings during the week prior to completing the survey.

Secondary analyses on PFS data examine the respondents’ reports of medication use, and of cravings in association with other variables such as treatment duration, days of substance use, and days of AA/NA attendance. So far, our analyses highlight the importance of monitoring patients’ cravings throughout their treatment. They also show that relatively few patients (60 out of 500 respondents, 12%) report using medications for substance-related disorders. Findings from this study have been accepted for presentation at the upcoming annual conference of the American Psychological Association that will be held in Boston later this year.

Characteristics of Patients Discharged Against Medical Advice.

Studies conducted in clinical settings often show that certain patient characteristics are associated with greater likelihood of discharge against medical advice (AMA). Based on findings from recently conducted studies, we examined to what extent AMA discharges at AdCare Hospital’s detoxification and rehabilitation units are associated with age, gender, ethnicity, types of substance dependence, and presence of co-occurring psychiatric disorders. Characteristics of patients who completed inpatient detoxification and/or rehabilitation treatment were compared to characteristics of those who were discharged AMA by examining medical record data from a 12-month period. We found that patients discharged AMA were significantly younger than those who completed treatment, and were more likely to have opioid dependence, sedative-hypnotic dependence, and co-occurring psychotic disorders.

Our findings provide additional evidence that patient characteristics play a role in the prevalence of AMA discharges, and pose the question of whether implementation of targeted regimens with these patients would contribute to them following through with further treatment. Drs. Patrice Muchowski and Monika Kolodziej, and Susan Hillis from AdCare Hospital as well as Drs. Shelly Greenfield and Roger Weiss from McLean Hospital co-authored a presentation of the findings at the annual conference of the College on Problems of Drug Dependence (CPDD) that was held in Quebec City, Canada in June 2007.