TY - JOUR
T1 - Psychopathology as a Predictor of Treatment Outcome in Alcoholics
AU - Rounsaville, Bruce J.
AU - Dolinsky, Zelig S.
AU - Babor, Thomas F.
AU - Meyer, Roger E.
PY - 1987/6
Y1 - 1987/6
N2 - We performed a one-year follow-up study of 266 alcoholics who had received extensive psychiatric assessment, including diagnosis with the National Institute of Mental Health Diagnostic Interview Schedule and DSM-III criteria, during their index treatment episode. The aims were to (1) evaluate the relationship between additional DSM-III diagnoses in alcoholics and outcome at follow-up, (2) assess the relative prognostic power of different ways of measuring psychopathology by comparing categorical DSM-III diagnoses and a global symptom severity measure, and (3) assess whether ratings of psychopathology add to the prognostic power of an alcoholdependence measure. While coexistent psychiatric diagnoses generally predicted poorer treatment outcome, there were significant interactions in the relationship between diagnoses and treatment outcome for men and women. For men, having an additional diagnosis of major depression, antisocial personality, or drug abuse was associated with poorer outcome. For women, having major depression was associated with a better outcome in drinking-related measures, while antisocial personality and drug abuse were associated with poorer prognosis. The value of determining psychiatric diagnosis was supported by covariance analyses that suggested that prognostic significance of specific disorders was not accounted for by general psychopathology or general dependence dimensions.
AB - We performed a one-year follow-up study of 266 alcoholics who had received extensive psychiatric assessment, including diagnosis with the National Institute of Mental Health Diagnostic Interview Schedule and DSM-III criteria, during their index treatment episode. The aims were to (1) evaluate the relationship between additional DSM-III diagnoses in alcoholics and outcome at follow-up, (2) assess the relative prognostic power of different ways of measuring psychopathology by comparing categorical DSM-III diagnoses and a global symptom severity measure, and (3) assess whether ratings of psychopathology add to the prognostic power of an alcoholdependence measure. While coexistent psychiatric diagnoses generally predicted poorer treatment outcome, there were significant interactions in the relationship between diagnoses and treatment outcome for men and women. For men, having an additional diagnosis of major depression, antisocial personality, or drug abuse was associated with poorer outcome. For women, having major depression was associated with a better outcome in drinking-related measures, while antisocial personality and drug abuse were associated with poorer prognosis. The value of determining psychiatric diagnosis was supported by covariance analyses that suggested that prognostic significance of specific disorders was not accounted for by general psychopathology or general dependence dimensions.
UR - http://www.scopus.com/inward/record.url?scp=0023176663&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0023176663&partnerID=8YFLogxK
U2 - 10.1001/archpsyc.1987.01800180015002
DO - 10.1001/archpsyc.1987.01800180015002
M3 - Article
C2 - 3579499
AN - SCOPUS:0023176663
SN - 0003-990X
VL - 44
SP - 505
EP - 513
JO - Archives of General Psychiatry
JF - Archives of General Psychiatry
IS - 6
ER -