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Hogrefe, SUCHT: Interdisciplinary Journal of Addiction Research, 5(63), p. 289-296, 2017

DOI: 10.1024/0939-5911/a000505

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Differentiating Treatment-Seeking Substance-Use Disordered Patients: Support for a Staging Model

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Abstract. Background and Aims: Profiling according to a staging model could be useful for differentiating among the heterogeneous group of treatment-seeking substance use disorder (SUD) patients. The staging model that was evaluated in this study is analogous to the hierarchical Tumor-Nodes-Metastasis (TNM) model in oncology. The proposed model distinguishes profiles derived from the following stages of addiction: (0) addicted, but not severely; (1) severely addicted, but without psychiatric comorbidity or social disintegration; (2) severely addicted with psychiatric comorbidity, but with no social disintegration; and (3) severely addicted in combination with psychiatric comorbidity and social disintegration. Methods: We tested whether subgroups suggested by the staging model for SUDs could be identified among Dutch treatment-seeking SUD patients (N = 6,602). Results: The profile of 5,153 patients (80.9 %) fitted the staging model, and the model was invariant for age, sex, and primary substance of abuse. The majority of the patients not fitting the model (N = 906 of 1,202; 75.4 %) were not severely addicted but were in treatment or had recently been treated for a comorbid psychiatric disorder. When psychiatric treatment was removed as an indicator for the presence of psychiatric comorbidity, the fit increased to 87.1 %. Conclusions: These results support the validity of the hierarchical staging model, which may be used to match patients to specific treatment regimens. Keywords: staging, profiling, disease progression, addiction severity, treatment-seeking patients, substance-use disorders