Introduction

The impact of psychiatric comorbidity and addiction features throughout the course of addiction has been widely studied. This is a naturalistic study conducted in an outpatient unit, where treatment follow-up studies are scarce compared to studies including inpatients or those under experimental conditions. Therefore, this follow-up study aims to analyze the treatment adherence and abstinence of outpatients with SUD (Substance Use Disorders) according to addiction severity and psychiatric comorbidity.

Methods

The current six-month follow-up study examined 404 SUD outpatients. Psychiatric comorbidity, addiction severity, substance consumption and treatment adherence were systematically evaluated using semistructured interviews. Survival analyses were conducted to compare the time of treatment adherence and abstinence in a bivariate and multivariate level.

Results

A progressive dropout was observed, reaching 32.2% of dropouts at the six-month follow-up. More than 50% achieved abstinence during the first month and similar percentages were found until the six-month follow-up.

At the multivariate level, treatment adherence, cannabis use disorder and polyconsumption were independently associated with earlier dropout. ADHD was the only mental disorder significantly related with dropout. Regarding substance consumption, the time of abstinence was independently associated with months of treatment adherence and the achievement of abstinence before starting treatment. In general, dual diagnosis was associated with less time of abstinence, but only depressive disorder across the lifespan was related to less time of abstinence in the multivariate model.

Conclusion

These findings highlight the importance of an accurate diagnosis at the beginning of treatment, especially in an outpatient setting, addressing the treatment needs and promoting strategies that improve treatment adherence and reduce the risk of relapses.

中文翻译：

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根据成瘾严重程度和精神病合并症对药物滥用障碍患者的治疗保留和禁欲：在门诊进行的为期六个月的随访研究

介绍

在成瘾过程中，精神病合并症和成瘾特征的影响已得到广泛研究。这是在门诊部进行的自然研究，与包括住院患者或处于实验条件下的研究相比，治疗随访研究很少。因此，这项追踪研究旨在根据成瘾的严重程度和精神病合并症来分析门诊SUD（物质使用障碍）的治疗依从性和禁欲。

方法

当前的六个月随访研究检查了404名SUD门诊患者。使用半结构化访谈系统评估了精神病合并症，成瘾严重程度，药物消耗和治疗依从性。进行生存分析，以双变量和多变量水平比较治疗依从性和禁欲时间。

结果

观察到逐步退出，在六个月的随访中达到退出的32.2％。在第一个月内，有超过50％的人戒酒，直到六个月的随访期，发现了类似的百分比。

在多变量水平上，治疗依从性，大麻使用障碍和多餐消费与早期辍学独立相关。多动症是唯一与辍学显着相关的精神障碍。关于药物消耗，禁欲时间与开始治疗前几个月的依从性和禁欲的实现独立相关。一般而言，在多变量模型中，双重诊断与较少的禁欲时间有关，但只有整个生命期的抑郁症与较少的禁欲时间有关。

结论

这些发现凸显了在治疗开始时进行准确诊断的重要性，尤其是在门诊患者中，解决了治疗需求并提出了改善治疗依从性并降低复发风险的策略。