Reduction in mental distress among substance users receiving inpatient treatment

Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis.We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress.The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.In studies of the general population, the incidence of mental disorders among people with substance use disorders (SUD) varies according to catchment area and methodology. It is assumed that 30 - 40% of people with alcohol related disorders, and 40 - 50% of people with other SUD, also have a psychiatric disorder [1-5]. The incidence of psychiatric disorders among individuals with SUD in treatment is even higher [6,7]. Psychiatric disorders have repeatedly been shown to influence treatment outcomes in different treatment seeking SUD samples [8-10].The psychiatric disorders most commonly associated with SUD are anxiety and depression [11-13]. Symptoms of anxiety and depression have been found to influence the course of treatment [10], and to predict relapse in SUD [14-16]. On the other hand, several studies have found that anxiety and depressive symptoms among SUD patients often are passing, representing toxic or withdrawal effects that resolve in response to abstinence or to