Impact of Psychiatric Comorbidity on the In-Treatment Outcomes of Cocaine-Dependent Patients in Therapeutic Communities

Abstract

ABSTRACT. Background: This study aimed to explore the association between psychiatric comorbidity and treatment outcomes in therapeutic communities (TCs). Methods: A prospective longitudinal descriptive design was used. A baseline psychopathological assessment was performed within the first 15 to 20 days of treatment in the TCs. The length of treatment stay was computed for each individual. The study was conducted in the region of Andalusia (Spain). The participants were 218 cocaine-dependent individuals. Psychopathological assessment was performed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). The outcome measures were retention, defined as the time in TC treatment (number of days), and the patient's assessment upon leaving the TC. Results: The number of psychopathological comorbidities present in the last year among the patients was high (57.8%) and was associated with a worse response to treatment (P =.004). The patients with co-occurring psychiatric disorders had a decreased probability of remaining in the TCs compared with patients who only presented with substance use disorders (hazards ratio = 1.61). Conclusions: Psychiatric comorbidity predicts cocaine-dependent individuals’ likelihood of remaining in residential treatment.