Longitudinal Course of Clients With Co-occurring Schizophrenia-Spectrum and Substance Use Disorders in Urban Mental Health Centers: A 7-Year Prospective Study.

Abstract

OBJECTIVE:

A previous longitudinal study in rural New Hampshire showed that community mental health center clients with co-occurring schizophrenia-spectrum and substance use disorders (SZ/SUD) improved steadily and substantially over 10 years. The current study examined 7 years of prospective clinical and functional outcomes among inner-city Connecticut (CT) community mental health center clients with SZ/SUD.

METHOD:

Participants were 150 adults with SZ/SUD, selected for high service needs, in 2 inner-city mental health centers in CT. Initially, all received integrated mental health and substance abuse treatments for at least the first 3 years as part of a clinical trial. Assessments at baseline and yearly over 7 years measured progress toward 6 target clinical and functional outcomes: absence of psychiatric symptoms, remission of substance abuse, independent housing, competitive employment, social contact with non-users of substances, and life satisfaction.

RESULTS:

The CT SZ/SUD participants improved significantly on 5 of the 6 main outcomes: absence of psychiatric symptoms (45%-70%), remission of substance use disorders (8%-61%), independent housing (33%-47%), competitive employment (14%-28%), and life satisfaction (35%-53%). Only social contact with nonusers of substances was unimproved (14%-17%).

CONCLUSIONS:

Many urban community mental health center clients with SZ/SUD and access to integrated treatment improve significantly on clinical, vocational, residential, and life satisfaction outcomes over time, similar to clients with SZ/SUD in rural areas. Thus, the long-term course for people with SZ/SUD is variable but often quite positive.

• Authors: Robert E Drake, Alison E Luciano, Kim T Mueser, Nancy H Covell, Susan M Essock, Haiyi Xie, Gregory J McHugo
• Journal: Schizophrenia bulletin (Schizophr Bull) Vol. 42 Issue 1 Pg. 202-11 (Jan 2016) ISSN: 1745-1701 [Electronic] United States
• PMID: 26294706 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: [email protected].

Topics

• Adult
• Alcoholism
• Cocaine-Related Disorders
• Community Mental Health Services
• Connecticut
• Diagnosis, Dual (Psychiatry)
• Disease Progression
• Employment
• Female
• Housing
• Humans
• Independent Living
• Longitudinal Studies
• Male
• Marijuana Abuse
• Middle Aged
• Personal Satisfaction
• Prospective Studies
• Psychotic Disorders (complications)
• Remission Induction
• Schizophrenia (complications)
• Social Participation
• Substance-Related Disorders (complications)
• Urban Population
• Young Adult