Outpatient Adolescent Treatment for Comorbid Substance Use and Internalizing Disorders

Sponsor

Medical University of South Carolina (Other)

Overall Status

Completed

CT.gov ID

NCT00438685

Collaborator

National Institute on Drug Abuse (NIDA) (NIH)

Enrollment

Location

Duration (Months)

0.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth range from 25% up to 82%, and youths with a dual diagnosis have worse outcomes and are more than twice as costly to treat than their counterparts with no comorbidity. This project was a pilot test of a new treatment, OPTION-A, which was adapted from Multisystemic Therapist (MST) and other evidence-based interventions to specifically treat youth presenting for outpatient treatment of comorbid substance use and internalizing disorders. The project was a randomized controlled pilot trial comparing the experimental treatment to usual services in the community.

Condition or Disease	Intervention/Treatment	Phase
Substance-Related Disorders Depressive Disorder Anxiety Disorder	Behavioral: Outpatient MST/OPTION-A Behavioral: Usual Services	Phase 1

Detailed Description

Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth are high and youths with a dual diagnosis are more costly to treat. At the time of this study, however, no outpatient treatments had been tested specifically for treating youth with co-occurring substance use disorders and mental health diagnoses. The current project aimed to adapt and evaluate Multisystemic Therapy (MST), a well validated treatment for chronic behavioral problems or serious emotional disturbance in adolescents, to treat dually diagnosed youth using an outpatient model of service delivery.

A pilot trial was conducted with 40 dually diagnosed youth randomly assigned to treatment conditions, with 20 receiving the experimental treatment (OPTION-A) and 20 receiving usual outpatient services. Specific aims were:

Specific Aim 1: The primary aim of the present research was to adapt and test OPTION-A for use in outpatient settings to treat youth diagnosed with a substance use disorder and comorbid internalizing disorder. We hypothesized that youth receiving OPTION-A would exhibit significantly less drug use (e.g., youth self-reports and urine screens) than control youth who received usual services, and that youth receiving OPTION-A would exhibit significant improvement on indices of mental health (e.g., combined youth and caregiver reports on diagnostic interviews and youth, caregiver, and teacher reports of internalizing symptoms) compared to control youth Specific Aim 2: In addition to improved symptomatology, the current research aimed to test the effectiveness of OPTION-A to improve youth functioning in other domains pertinent to successful adolescent development. We hypothesized that youth receiving OPTION-A would evidence improved behavioral (e.g., youth, caregiver, and teacher reports of externalizing), school (e.g., school attendance), and family functioning (e.g., youth and caregiver reports of family adaptability and cohesion) compared to control youth who received usual services.

Specific Aim 3: The final aim of the proposed research was to provide services that are more acceptable to consumers than are usual services provided in the community. We hypothesized that youth and families receiving OPTION-A would experience significantly greater consumer satisfaction than control youth and families who received usual services.

Study Design

Study Type:

Interventional

Allocation:

Randomized

Intervention Model:

Factorial Assignment

Masking:

Single (Outcomes Assessor)

Primary Purpose:

Treatment

Official Title:

Development of Outpatient MST for Dually Diagnosed Youth

Study Start Date :

Oct 1, 2004

Actual Primary Completion Date :

Aug 1, 2007

Actual Study Completion Date :

Sep 1, 2010

Outcome Measures

Primary Outcome Measures

Urine Drug Screen at 4 weeks, 8 weeks, 12 weeks, 24 weeks []
Score on Depression/Anxiety Scale (RCADS) at 4 weeks, 8 weeks, 12 weeks, 24 weeks []

Secondary Outcome Measures

Measured at Intake, 3 Months, and 6 Months []
Global assessment of symptoms []
Parenting []
School []
Behavioral []
Family relationship/communication/problem solving []
Consumer satisfaction []
Daily Drug/Alcohol use []

Eligibility Criteria

Criteria

Ages Eligible for Study:

12 Years to 17 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Presentation for outpatient treatment
12 to 17 years of age
Youth residing with at least one adult caregiver who serves as a parent figure
Substance Abuse or Dependence Disorder
Axis I Internalizing Disorder (Mood Disorder or Anxiety Disorder), based on the Diagnostic Interview Schedule for Children (DISC-IV; Shaffer, Fisher, Lucas, Dulcan, & Schwab-Stone, 2000)

Exclusion Criteria:

Pervasive Developmental Disorder
Psychotic Disorder
Severe or profound mental retardation (IQ of 45 or below)
Families previously receiving Multisystemic Therapy

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Family Services Research Center	Charleston	South Carolina	United States	29425

Sponsors and Collaborators

Medical University of South Carolina
National Institute on Drug Abuse (NIDA)

Investigators

Principal Investigator: Ashli J Sheidow, PhD, Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Family Services Research Center
Study Chair: Scott W Henggeler, PhD, Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Family Services Research Center