The co-occurrence of psychiatric and substance use diagnoses in adolescents in different service systems: Frequency, recognition, cost, and outcomes

King, Richard; Gaines, Lawrence S.; Lambert, E. Warren; Summerfelt, Wm. Thomas; Bickman, Leonard

doi:10.1007/bf02287823

Cited by 90 publications

(64 citation statements)

References 38 publications

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“…ASU is vastly underidentified in these sectors, associated with a litany of co-occurring health problems, and predictive of high failure=recidivism rates, all resulting in enormous costs to families, communities, and government (King, Gaines, Lambert, Summerfelt, & Bickman, 2000). Even when ASU problems are identified, program staff and institutions within these sectors are often poorly equipped-lacking in training, procedures, and available resources-to properly manage them.…”

Section: Market Penetration: Barriers and Solutions To Meeting The Dementioning

confidence: 99%

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Hogue

Henderson

Ozechowski

et al. 2014

Journal of Clinical Child & Adolescent Psychology

146

120

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This article updates the evidence base on outpatient behavioral treatments for adolescent substance use (ASU) since publication of the previous review completed for this journal by Waldron and Turner (2008). It first summarizes the Waldron and Turner findings as well as those from more recent literature reviews and meta-analytic studies of ASU treatment. It then presents study design and methods criteria used to select 19 comparative studies subjected to Journal of Clinical Child & Adolescent Psychology level of support evaluation. These 19 studies are grouped by study category (efficacy or effectiveness) and described for sample characteristics, methodological quality, and substance use outcomes. Cumulative level of support designations are then made for each identified treatment approach: ecological family-based treatment, group cognitive-behavioral therapy, and individual cognitive-behavioral therapy are deemed Well Established; behavioral family-based treatment and motivational interviewing are deemed Probably Efficacious; drug counseling is deemed Possibly Efficacious; and four integrated treatment models combining more than one approach are deemed Well Established or Probably Efficacious. The remainder of the article (a) articulates fidelity, mediator, and moderator effects reported for evidence-based approaches since 2008 and (b) recommends four enhancements to the prevailing business model of ASU outpatient services to accelerate penetration of evidence-based approaches into the underserved consumer base: pursue partnerships with influential governmental systems, utilize web-based technology to extend reach and control costs, adapt effective methods for linking services across sectors of care, and promote uptake and sustainability by emphasizing return on investment. INTRODUCTIONThis article reviews the evidence base on outpatient behavioral treatments for adolescent substance use (Turner, Muck, Muck, Stephens, & Sukumar, 2004). Because practice guidelines in behavioral healthcare now favor on-site treatment over referral for comorbid disorders (see Sacks et al., 2013), behavioral therapists should be fully prepared to manage common ASU problems that present as a secondary reason for referral or an emergent treatment issue. Thus for behavioral health providers who serve teenage populations in a variety of settings, identifying effective treatments for ASU remains a top priority.The following two sections specify the area of intervention science surveyed in this update and recap the Waldron and Turner (2008) findings that are the launching point for review. The remainder of the article summarizes findings from other literature reviews and meta-analytic studies of ASU treatment published since 2008 and introduces the main contributions of the current review; defines the search parameters and inclusion criteria for identifying the final pool of 19 comparative studies subjected to the JCCAP evidence-based treatment evaluation criteria (Southam-Gerow & Prinstein, 2014); describes the main findings of these ...

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Section: Market Penetration: Barriers and Solutions To Meeting The Dementioning

confidence: 99%

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Hogue

Henderson

Ozechowski

et al. 2014

Journal of Clinical Child & Adolescent Psychology

146

120

View full text Add to dashboard Cite

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“…The consequences of these disorders (King et al, 2000;Gore et al, 2011;Mojtabai, 2011;Whiteford et al, 2013), particularly when co-occurring, are increasingly recognised as a major public health issue and their global health and economic burden is high. Mental health and alcohol disorders contribute to 183.9 million Disability Adjusted Life Years annually, peaking in young adults (Whiteford et al, 2013), and treatment of comorbid mental health and alcohol disorders is both more complex (Tiet and Mausbach, 2007;Connolly et al, 2011) and more costly than single disorders (King et al, 2000), with worse projected outcomes (Bruce et al, 2005). As such, understanding how these joint conditions emerge is of great interest to researchers, policy makers and health professionals (Rush and Koegl, 2008;Swendsen et al, 2009;Cerda et al, 2010;Green et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Does early socio-economic disadvantage predict comorbid alcohol and mental health disorders?

Salom

Williams

Najman

et al. 2014

Drug and Alcohol Dependence

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Please cite this article as: Salom, C.L., Williams, G.M., Najman, J.M., Alati, R.,Does early socio-economic disadvantage predict comorbid alcohol and mental health disorders?, Drug and Alcohol Dependence (2014), http://dx.doi.org/10. 1016/j.drugalcdep.2014.06.011 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…This comorbidity entailed additional costs of $437 per child ($812 versus $375) for total health care services in comparison to the children with ADHD but no comorbidity. This effect of comorbidity on costs is common throughout the literature (10) and may denote the need for differential treatments to reduce expenses and reach better treatment outcomes. Although these studies illuminate the burden of illness associated with ADHD, no studies, to our knowledge, have addressed the cost and cost-effectiveness of specific treatments for ADHD in the United States.…”

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confidence: 95%

Cost-Effectiveness of ADHD Treatments: Findings From the Multimodal Treatment Study of Children With ADHD

Talbott¹,

Jensen²

2007

Yearbook of Psychiatry and Applied Mental Health

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Objective: Attention deficit hyperactivity disorder (ADHD) is a costly public health problem. To the authors' knowledge, this is the first study on the cost-effectiveness of the major forms of ADHD treatments used in NIMH's Multimodal Treatment Study of Children With ADHD (MTA Study).Method: Five hundred seventy-nine children with ADHD, combined type, ages 7 to 9.9, were assigned to 14 months of medication management, behavioral treatment, both combined, or community care. Services were tallied throughout the study, including medication, health care visits, behavioral treatments, and rental costs. Provider specialty, total time, and number of visits with providers were used to calculate costs, adjusted to FY 2000 dollars with the consumer price index.Results: Treatment costs varied fourfold, with medication management being the least expensive, followed by behavioral treatment, and then combined treatment. Lower costs of medication treatment were found in the community care group, reflecting the less intensive (and less effective) nature of community-delivered treatment. Medical management was more effective but more costly than community care and more cost-effective than combination treatment and behavioral treatment alone. Under some conditions, combination treatment (medical management and psychotherapy) were somewhat more cost-effective, as demonstrated by lower costs per additional child "normalized" among children with multiple comorbid disorders.Conclusions: Medical management treatment, although not as effective as combined medical management and behavioral treatment, is likely to be more cost-effective in routine treatment for children with ADHD, particularly those without comorbid disorders. For some children with comorbid disorders, it may be cost-effective to provide combination treatment.

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The co-occurrence of psychiatric and substance use diagnoses in adolescents in different service systems: Frequency, recognition, cost, and outcomes

Cited by 90 publications

References 38 publications

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Does early socio-economic disadvantage predict comorbid alcohol and mental health disorders?

Cost-Effectiveness of ADHD Treatments: Findings From the Multimodal Treatment Study of Children With ADHD

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