Prognostic Significance of Psychopathology in Treated Opiate Addicts: A 2.5-Year Follow-up Study

doi:10.1001/archpsyc.1986.01800080025004

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Vol. 43 No. 8, August 1986

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Prognostic Significance of Psychopathology in Treated Opiate Addicts

A 2.5-Year Follow-up Study

Bruce J. Rounsaville, MD; Thomas R. Kosten, MD; Myrna M. Weissman, PhD; Herbert D. Kleber, MD

Arch Gen Psychiatry. 1986;43(8):739-745.

Abstract

• Two different methods for assessing psychopathology inopiate addicts were compared as predictors of long-term treatmentoutcome: (1) categorical psychiatric diagnosis using the Schedulefor Affective Disorders and Schizophrenia— Lifetime Versionand the Research Diagnostic Criteria and (2) global rating ofpsychiatric impairment using the Psychiatric Severity scaleof the Addiction Severity Index (ASI). Follow-up interviewswere completed 2.5 years after treatment seeking in 76% of asample of 361 opiate addicts. Five dimensions of treatment outcomewere assessed, including current functioning, psychosocial adjustment,substance use impairment, legal problems, and medical disability.Most lifetime psychiatric disorders with a prevalence of greaterthan 10% were significantly related to the outcome dimensionsof current functioning and/or psychosocial adjustment and wereunrelated to substance use impairment, legal problems, and medicaldisability. The ASI Psychiatric Severity rating more robustlypredicted poorer functioning in the same two areas and lesssevere legal problems. While controlling for ASI PsychiatricSeverity, the only Research Diagnostic Criteria diagnosis thatremained significantly related to treatment outcome was majordepression, suggesting that, as regards their prognostic characteristics,the other diagnoses are accounted for by a global underlyingseverity dimension.

Author Affiliations

From the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.

Footnotes

Accepted for publication Nov 22, 1985.

Reprint requests to Substance Abuse Treatment Unit, Yale Schoolof Medicine, 904 Howard Ave, Suite 2E, New Haven, CT 06519 (DrRounsaville).

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