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Depression's moderation of the effectiveness of intensive case management with substance-dependent women on temporary assistance for needy families: outpatient substance use disorder treatment utilization and outcomes.
- Source :
-
Journal of studies on alcohol and drugs [J Stud Alcohol Drugs] 2011 Mar; Vol. 72 (2), pp. 297-307. - Publication Year :
- 2011
-
Abstract
- Objective: Intensive case management (ICM) is effective for facilitating entry into and retention in outpatient substance use disorder treatment (OSUDT) for low-income substance-dependent women; however, no studies have specifically examined the moderating impact of depressive symptoms on ICM. The purpose of this study was to investigate whether depressive symptoms moderated ICM's effect on OSUDT engagement, attendance, and outcomes for substance-dependent women on Temporary Assistance for Needy Families (TANF). It was hypothesized that highly depressed women would demonstrate worse outcomes on all indicators.<br />Method: Logistic regression and generalized estimating equations were used to determine depression's moderating impact on ICM in a secondary analysis of data from a randomized controlled trial comparing the effectiveness of ICM to usual care provided by local public assistance offices in Essex County, NJ. Substance-dependent women (N = 294) were recruited while being screened for TANF eligibility and were followed for 24 months.<br />Results: Findings revealed that high levels of depressive symptoms moderated the effectiveness of ICM in unexpected directions for two outcome variables. Subjects with high levels of depressive symptoms in ICM were (a) significantly more likely to engage in at least one treatment program than those in usual care and (b) associated with the fewest mean drinks per drinking day across the 24-month follow-up period. Independent effects for high levels of depressive symptoms and ICM were also found to positively influence engagement, attendance, and percentage days abstinent.<br />Conclusions: ICM is effective for substance-dependent women with a broad spectrum of depressive symptoms in enhancing OSUDT utilization and outcomes.
- Subjects :
- Adult
Ambulatory Care economics
Case Management economics
Case Management organization & administration
Depression economics
Depressive Disorder economics
Employment economics
Employment psychology
Female
Humans
Mental Disorders economics
Middle Aged
Outpatients
Patient Compliance
Psychiatric Status Rating Scales
Social Welfare economics
Standard of Care
Substance-Related Disorders economics
Substance-Related Disorders epidemiology
Treatment Outcome
Young Adult
Case Management classification
Depressive Disorder therapy
Mental Disorders therapy
Public Assistance economics
Public Assistance statistics & numerical data
Substance-Related Disorders therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1938-4114
- Volume :
- 72
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of studies on alcohol and drugs
- Publication Type :
- Academic Journal
- Accession number :
- 21388603
- Full Text :
- https://doi.org/10.15288/jsad.2011.72.297