Background Cognitive function is a challenge for many SUD patients, and residential SUD treatment is cognitively demanding. Treatment retention is a predictor for success in SUD treatment, and the literature links low cognitive function to increased dropout rates. In our study we investigate cognitive function and dropout in a residential SUD treatment setting, also accounting for psychological distress. Methods We screened a cohort (N = 142) of inpatients for cognitive function (MoCA®) and psychological distress (SCL-10) and calculated the relative risk for dropping out if over versus under the respective cut-off values (<26 and >1.85), and sex, and age-group (<23 years). We also employed a logistic regression with dropout as outcome and MoCA- and SCL-10 scores, and age and days before testing as input. Results Dropout risk was higher (RR = 1.70) if scoring below MoCA cut-off, and for those younger than 23 years (RR = 2.36). The other variables did not influence dropout risk. MoCA raw scores, age, and SCL-10 were associated with dropout (p < .05); with lower symptoms of psychological distress predicting increased dropout. The interaction between MoCA and SCL-10 scores was not significant (p = .26). Conclusions SUD patients should routinely be screened for cognitive impairment, as it predicts dropout. Screenings should be ensued by appropriate adaptations to treatment and further assessment. The MoCA is a useful screening tool for this, independent of psychological distress. Future studies should replicate our findings, investigate specific interventions, and establish SUD population norms for the MoCA.

Aim: To test the dimensional structure of the Symptom Check List-90-Revised (SCL-90-R) among inpatients with substance use disorders (SUD), and to examine whether the Global Severity Index (GSI) scores discriminated between SUD patients and a general Norwegian population sample. The concurrent validity of the SCL-90-R was also examined. Methods: The sample included 85 patients from inpatient SUD treatment clinics in Norway. The patients responded to a survey in the week before they were discharged from treatment. Results: The SCL-90-R is a feasible instrument for measuring general distress among patients with SUD. The patients reported higher scores on the GSI than the general population. This is coherent with the high prevalence of co-occurring psychiatric symptoms in the SUD population. The concurrent validity of SCL-90-R was satisfactory. Conclusion: The SCL-90-R is unidimensional, and the use of the earlier established factor structure is discussable. The GSI score may be a feasible alternative.

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Patients perceived psychological and physical health as important areas for improvement. There were differences between patients with co-occurring disorders and those with substance use disorders only in several measures. It is important to acknowledge that patients with substance use disorders and co-occurring mental problems are heterogeneous groups with unique but overlapping needs.