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Relation of depression diagnoses to 2-year outcomes in cocaine-dependent patients in a randomized continuing care
James R McKay1, Helen M Pettinati, Rebecca Morrison
1Department of Psychiatry, University of Pennsylvania, and Veterans Affairs Medical Center, Philadelphia 19104, USA.
Abstract:
This study examined the relation between depression diagnoses and outcomes in 132 cocaine-dependent patients who were randomized to relapse prevention (RP) or standard 12-step focused group continuing care and followed for 2 years. Depressed patients attended more treatment sessions and had more cocaine-free urines during treatment than participants without depression, but they drank alcohol more frequently before treatment and during the 18-month posttreatment follow-up. Cocaine outcomes in depressed patients deteriorated to a greater degree after treatment than did cocaine outcomes in patients without depression, particularly in patients in RP who had a current depressive disorder at baseline. The best alcohol outcomes were obtained in nondepressed patients who received RP. The results suggest that extended continuing care treatment may be warranted for cocaine-dependent patients with co-occurring depressive disorders.