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Dissertation
Treatment utilization and community adjustment of dually diagnosed and singly diagnosed/psychiatric adults at a partial hospital program
Doctor of Philosophy (Ph.D.), Medical College of Pennsylvania and Hahnemann University
Dec 1999
DOI:
https://doi.org/10.17918/00008298
Abstract
In this research, differences were elucidated between chronically mentally iii patients presenting with and without comorbid substance use disorder diagnoses, who sought treatment at a partial hospital program. Data from 96 dually diagnosed (DD) patients and 93 singly diagnosed (SD) patients were compared. Differences were examined in the areas of (1) demographic characteristics, (2) utilization of the program, and (3) treatment outcome. Dually diagnosed patients had a significantly greater hospitalization history when compared to SD patients, due to DDs' substance use history. The DD group had a greater history of arrests than the SD group, also due to substance-related infractions of the law. Regarding treatment utilization, as predicted, DDs left the program earlier than SDs. Significantly more DDs than SDs dropped out of the program during their second month in treatment. No difference in type of discharge or track record of attendance was found between the groups. Regarding community adjustment, there was no difference in the number and length of hospitalizations required by patients in either group during their course of treatment at the program. However, DDs required hospitalization earlier, most notably at around the ninth month of treatment. Contrary to initial hypothesis, both groups were found to be functioning initially at a similar level, as measured by GAF and SLOF scores. On the GAF, both groups demonstrated significant improvement over time. On the SLOF, both groups demonstrated significant improvement in interpersonal relationships over time, although there was no change for either group regarding work skills. Results indicated that a highly-structured program, which offered a novel approach to treating both DD and SD patients within a holistic model, served as a catalyst for change for both of these groups. Contrary to reports in the research literature, the DD patients in this study benefited from the program, to the same degree as the SD patients. Moreover, during their course of treatment, DD patients utilized the same number of inpatient services as SDs, despite their addiction histories, again suggesting a positive effect of the program. Ways to target particular timepoints for risks of dropout or rehospitalization were addressed.
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Details
- Title
- Treatment utilization and community adjustment of dually diagnosed and singly diagnosed/psychiatric adults at a partial hospital program
- Creators
- Stephanie Ann Olszowka Sassoon
- Awarding Institution
- Medical College of Pennsylvania and Hahnemann University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Medical College of Pennsylvania and Hahnemann University; Philadelphia, Pennsylvania
- Number of pages
- x, 160 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002); Clinical and Health Psychology [Historical]; School of Health Professions (1998-2000)
- Other Identifier
- 991021888772004721