André Q C Miguel1, Brian D Kiluk2, Theresa A Babuscio2, Charla Nich2, Jair J Mari3, Kathleen M Carroll2. 1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil. Electronic address: andre.miguel@yale.edu. 2. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States. 3. Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
Abstract
BACKGROUND: Substantial efforts have been made to identify clinically meaningful non-abstinence cocaine use outcomes by establishing associations between targeted drug use outcomes and long-term functional improvements. Psychiatric symptomatology is prevalent among those seeking treatment for cocaine use disorder (CUD). Establishing an association between cocaine use outcomes and improvements in psychiatric symptomatology would support clinical validity to these outcome measures. METHOD: With data pooled from 5 clinical trials evaluating treatment for CUD (n = 474) multiple linear mixed models were conducted to determine how five specific cocaine use outcome measures performed in terms of improvements in psychiatric symptomatology assessed with the Brief Symptom Inventory (BSI) at baseline, end-of-treatment and 6-month follow-up. RESULTS: Three outcome measures performed comparably well (maximum days of consecutive abstinence, 3 or more weeks of abstinence and end-of-treatment abstinence), in that they consistently predicted improvements in several BSI composite scores at the end-of-treatment and follow-up. The poorer-performing outcome measures were complete abstinence during treatment, percentage of negative urinalysis results and percentage of days abstinent. Improvements in the BSI's global index of distress, positive symptom total, as well as depression, interpersonal sensitivity, obsessive-compulsion, phobic-anxiety and psychoticism dimensions were consistently associated with outcome effects, while anxiety, hostility, paranoid ideation and somatization were not. CONCLUSION: The consistent short and long-term association of three outcome measures evaluated here (maximum days of consecutive abstinence, 3 or more weeks of abstinence and end-of-treatment abstinence) with improvements psychiatric symptomatology adds support to their clinical relevance as well as their adoption in trials and treatments for CUD.
BACKGROUND: Substantial efforts have been made to identify clinically meaningful non-abstinence cocaine use outcomes by establishing associations between targeted drug use outcomes and long-term functional improvements. Psychiatric symptomatology is prevalent among those seeking treatment for cocaine use disorder (CUD). Establishing an association between cocaine use outcomes and improvements in psychiatric symptomatology would support clinical validity to these outcome measures. METHOD: With data pooled from 5 clinical trials evaluating treatment for CUD (n = 474) multiple linear mixed models were conducted to determine how five specific cocaine use outcome measures performed in terms of improvements in psychiatric symptomatology assessed with the Brief Symptom Inventory (BSI) at baseline, end-of-treatment and 6-month follow-up. RESULTS: Three outcome measures performed comparably well (maximum days of consecutive abstinence, 3 or more weeks of abstinence and end-of-treatment abstinence), in that they consistently predicted improvements in several BSI composite scores at the end-of-treatment and follow-up. The poorer-performing outcome measures were complete abstinence during treatment, percentage of negative urinalysis results and percentage of days abstinent. Improvements in the BSI's global index of distress, positive symptom total, as well as depression, interpersonal sensitivity, obsessive-compulsion, phobic-anxiety and psychoticism dimensions were consistently associated with outcome effects, while anxiety, hostility, paranoid ideation and somatization were not. CONCLUSION: The consistent short and long-term association of three outcome measures evaluated here (maximum days of consecutive abstinence, 3 or more weeks of abstinence and end-of-treatment abstinence) with improvements psychiatric symptomatology adds support to their clinical relevance as well as their adoption in trials and treatments for CUD.
Authors: John M Roll; Nancy M Petry; Maxine L Stitzer; Mary L Brecht; Jessica M Peirce; Michael J McCann; Jack Blaine; Marilyn MacDonald; Joan DiMaria; Leroy Lucero; Scott Kellogg Journal: Am J Psychiatry Date: 2006-11 Impact factor: 18.112
Authors: Kathleen M Carroll; Charla Nich; Elise E DeVito; Julia M Shi; Mehmet Sofuoglu Journal: J Clin Psychiatry Date: 2018 Jan/Feb Impact factor: 4.384
Authors: Dennis M Donovan; George E Bigelow; Gregory S Brigham; Kathleen M Carroll; Allan J Cohen; John G Gardin; John A Hamilton; Marilyn A Huestis; John R Hughes; Robert Lindblad; G Alan Marlatt; Kenzie L Preston; Jeffrey A Selzer; Eugene C Somoza; Paul G Wakim; Elizabeth A Wells Journal: Addiction Date: 2011-07-22 Impact factor: 6.526
Authors: Brian D Kiluk; Kathleen M Carroll; Amy Duhig; Daniel E Falk; Kyle Kampman; Shengan Lai; Raye Z Litten; David J McCann; Ivan D Montoya; Kenzie L Preston; Phil Skolnick; Constance Weisner; George Woody; Redonna Chandler; Michael J Detke; Kelly Dunn; Robert H Dworkin; Joanne Fertig; Jennifer Gewandter; F Gerard Moeller; Tatiana Ramey; Megan Ryan; Kenneth Silverman; Eric C Strain Journal: Drug Alcohol Depend Date: 2015-11-21 Impact factor: 4.492
Authors: Bridget F Grant; Frederick S Stinson; Deborah A Dawson; S Patricia Chou; Mary C Dufour; Wilson Compton; Roger P Pickering; Kenneth Kaplan Journal: Arch Gen Psychiatry Date: 2004-08
Authors: Julian D Ford; Joel Gelernter; Judith S DeVoe; Wanli Zhang; Roger D Weiss; Kathleen Brady; Lindsay Farrer; Henry R Kranzler Journal: Drug Alcohol Depend Date: 2008-09-04 Impact factor: 4.492
Authors: André Q C Miguel; Brian D Kiluk; Corey R Roos; Theresa A Babuscio; Charla Nich; Jair J Mari; Kathleen M Carroll Journal: J Subst Abuse Treat Date: 2019-09-05
Authors: Corey R Roos; Charla Nich; Chung Jung Mun; Theresa A Babuscio; Justin Mendonca; André Q C Miguel; Elise E DeVito; Sarah W Yip; Katie Witkiewitz; Kathleen M Carroll; Brian D Kiluk Journal: Drug Alcohol Depend Date: 2019-10-21 Impact factor: 4.492
Authors: Brian D Kiluk; Corey R Roos; Mihaela Aslan; Ralitza Gueorguieva; Charla Nich; Theresa A Babuscio; Kathleen M Carroll Journal: Drug Alcohol Depend Date: 2021-09-20 Impact factor: 4.492
Authors: André Q C Miguel; Crystal L Smith; Ekaterina Burduli; John M Roll; Sterling M McPherson Journal: Exp Clin Psychopharmacol Date: 2021-06 Impact factor: 3.492
Authors: André de Queiroz Constantino Miguel; Clarice Sandi Madruga; Viviane Simões; Rodolfo Yamauchi; Claudio Jerônimo da Silva; Michael McDonell; Sterling McPherson; John Roll; Ronaldo Ramos Laranjeira; Jair de Jesus Mari Journal: Psicol Reflex Crit Date: 2019-07-15