Timko Christine, Finlay Andrea, Schultz Nicole R, Blonigen Daniel M
Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA 94304, USA; Stanford University School of Medicine, Stanford, CA 94305, USA.
Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA 94304, USA.
J Addict. 2016;2016:6793907. doi: 10.1155/2016/6793907. Epub 2016 Mar 28.
The purpose of this study was to examine the history of arrests among dually diagnosed patients entering treatment, compare groups with different histories on use of treatment and mutual-help groups and functioning, at intake to treatment and six-month, one-year, and two-year follow-ups, and examine correlates and predictors of legal functioning at the study endpoint. At treatment intake, 9.2% of patients had no arrest history, 56.3% had been arrested for nonviolent offenses only, and 34.5% had been arrested for violent offenses. At baseline, the violent group had used the most outpatient psychiatric treatment and reported poorer functioning (psychiatric, alcohol, drug, employment, and family/social). Both arrest groups had used more inpatient/residential treatment and had more mutual-help group participation than the no-arrest group. The arrest groups had higher likelihood of substance use disorder treatment or mutual-help group participation at follow-ups. Generally, all groups were comparable on functioning at follow-ups (with baseline functioning controlled). With baseline arrest status controlled, earlier predictors of more severe legal problems at the two-year follow-up were more severe psychological, family/social, and drug problems. Findings suggest that dually diagnosed patients with a history of arrests for violent offenses may achieve comparable treatment outcomes to those of patients with milder criminal histories.
本研究的目的是调查进入治疗的双重诊断患者的被捕史，比较在治疗开始时、六个月、一年和两年随访时，具有不同被捕史的患者在治疗和互助小组使用情况及功能方面的差异，并在研究终点检查法律功能的相关因素和预测指标。在治疗开始时，9.2%的患者没有被捕史，56.3%的患者仅因非暴力犯罪被捕，34.5%的患者因暴力犯罪被捕。在基线时，暴力犯罪组使用的门诊精神科治疗最多，且功能较差（精神、酒精、药物、就业及家庭/社会功能方面）。两个被捕组使用的住院/寄宿治疗更多，且比未被捕组更多地参与互助小组。在随访中，被捕组接受物质使用障碍治疗或参与互助小组的可能性更高。总体而言，在随访时（控制基线功能），所有组在功能方面具有可比性。在控制基线被捕状态的情况下，两年随访时更严重法律问题的早期预测因素是更严重的心理、家庭/社会及药物问题。研究结果表明，有暴力犯罪被捕史的双重诊断患者可能获得与犯罪史较轻患者相当的治疗效果。
