Budde D, Rounsaville B, Bryant K
Yale University Department of Psychiatry, New Haven, CT 06519.
J Subst Abuse Treat. 1992 Fall;9(4):337-42. doi: 10.1016/0740-5472(92)90028-m.
Given controversy about the comparative utility of inpatient and outpatient treatment for substance abusers, we compared samples of cocaine-abusing inpatients (n = 149) and outpatients (n = 149) regarding a range of clinical characteristics both at entrance into treatment and one year following this initial assessment. We wished to assess (a) whether inpatient treatment appeared justified on the basis of more severe clinical problems in this group of patients and (b) the comparative one-year outcome of patients treated in the two conditions. Regarding the presenting clinical picture, inpatients had more severe ratings in numerous areas, with heavier drug use, social impairment, and psychopathology. At one-year follow-up, the direction of clinical ratings had reversed in the two groups, with inpatients showing lower problem severity in several areas, particularly cocaine use and psychopathology. Thus, results of this nonrandomized study of inpatient and outpatient treatment suggest that decisions to hospitalize were made on a rational basis and that inpatient treatment had better long-term efficacy.
鉴于对于药物滥用者住院治疗和门诊治疗的相对效用存在争议，我们比较了可卡因滥用住院患者样本（n = 149）和门诊患者样本（n = 149）在治疗开始时以及初次评估后一年的一系列临床特征。我们希望评估：（a）基于该组患者更严重的临床问题，住院治疗是否合理；（b）两种治疗条件下患者的一年比较结果。就呈现的临床情况而言，住院患者在许多方面的评分更高，包括药物使用更严重、社会功能受损和精神病理学问题。在一年随访时，两组临床评分的方向发生了逆转，住院患者在几个方面的问题严重程度较低，尤其是可卡因使用和精神病理学问题。因此，这项关于住院治疗和门诊治疗的非随机研究结果表明，住院决策是基于合理依据做出的，且住院治疗具有更好的长期疗效。
