Treatment outcomes among adolescents with substance abuse problems: the relationship between comorbidities and post-treatment substance involvement

This study examines comorbid mental disorders in relation to post-treatment outcomes (12 months post-intake) among adolescents (N = 419) who entered three residential drug treatment programs. When contrasted with youths who had no comorbid mental disorders or youths with a single comorbid condition, those with combined internalizing and externalizing disorders (mixed comorbidity) had higher levels of substance-related problems and poly-drug use at entry to treatment, and poorer outcomes, e.g. relapse, particularly evident for drugs other than alcohol or marijuana. A significantly higher proportion of those with mixed comorbidity were admitted to short term residential treatment, as compared to long term residential care. However, the effects of comorbidity were independent of both planned and actual length of stay, suggesting that comorbidities can negatively impact treatment outcome in multiple ways, apart from length of stay. Since co-occurring problems appear to profoundly limit treatment effectiveness, treatment strategies that address comorbidity are needed to improve outcomes. (C) 2003 Elsevier Ltd. All rights reserved.