Serious Mental Illness in Heavy Drinkers Is Associated with Poor Treatment Outcomes in Outpatients with Co-occurring Disorders.

The objective of this study was to determine whether the interaction between type of serious mental illness (SMI) and pre-treatment drinking severity, assessed by ethyl glucuronide (EtG), predicts EtG-positive urine samples submitted during treatment in outpatients with co-occurring alcohol dependence and SMI. Seventy-nine participants were randomized to treatment-as-usual or treatment-as-usual and contingency management (CM) targeting alcohol abstinence. Generalized estimating equations were used to assess the interaction of pre-treatment drinking (heavy drinking or light drinking) and SMI diagnosis (major depression, bipolar, or schizophrenia-spectrum disorders) across a 12-week treatment period. In the overall sample, the interaction of drinking severity and SMI diagnosis (p = 0.006) was associated with alcohol abstinence. Exploratory analyses of the interaction term among participants randomized to CM (n = 40; p = 0.008) were associated with alcohol abstinence during CM. Type of SMI diagnosis was associated with treatment outcomes in individuals who engaged in heavy drinking, but not light drinking, prior to treatment.

RCT Entities:   Population Interventions Outcomes