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Treatment Setting/Psychiatric Symptom Interaction Effects on Alcohol Outcomes

Tiet Q, Finney J, Byrnes H, Tregor G, Liu L, Kuang S, Strumolo A. Treatment Setting/Psychiatric Symptom Interaction Effects on Alcohol Outcomes. Paper presented at: American Psychological Association Annual Convention; 2004 Jul 2; Honolulu, HI.


Objectives: This effectiveness study examined the effects of treatment setting (inpatient/residential versus outpatient) and the impact of psychiatric symptoms on alcohol use and problems of patients in Department of Veterans Affairs (VA) substance use disorder (SUD) treatment programs and how the effects of treatment settings vary across levels of psychiatric symptoms. Methods: Fifty-two VA SUD treatment programs across the country were randomly selected, and up to 50 new patients were randomly selected at each program. A brief, self-report version of the Addiction Severity Index (ASI), which provided composite scores on alcohol severity, psychiatric severity, and five other domains of functioning, was administered to patients at baseline and at 6-month follow-up (N = 1,319). Results: Lower ASI psychiatric composite scores (lower severity) and being treated in an inpatient treatment setting predicted lower ASI alcohol composite scores (better outcome) among VA SUD patients. There also was a significant interaction effect between psychiatric composite scores and treatment settings on alcohol composite scores longitudinally such that inpatient treatment setting had a stronger effect among SUD patients who had a higher psychiatric composite score at baseline. Conclusion: Patients tended to have better outcomes, on average, if they had lower levels of psychiatric problems or being treated in an inpatient setting. Furthermore, the beneficial effect of inpatient treatment is stronger among patients who had higher levels of psychiatric problems. Therefore, SUD patients with severe psychiatric symptoms should be considered for an inpatient SUD treatment.

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