Study Finds SUD Patients Less Likely to Receive Best-Practice Depression Care

Patients diagnosed with depression who also have co-occurring substance use disorders are less likely to receive depression care in line with established best practices, according to a study by researchers from the University of Michigan and the VA Ann Arbor Healthcare System.

The findings were published in the American Journal of Psychiatry.

For the study, researchers reviewed records of 53,034 patients diagnosed with a depressive disorder in the U.S. Veterans Health Administration’s 2017 fiscal year. They then looked at the association of comorbid SUDs with recommended depression treatment, which includes both medication and psychotherapy. The researchers found:

• Depression patients with co-occurring substance use disorders were 21% less likely to receive guideline-concordant treatment and 26% less likely to continue receiving antidepressant treatment
• Patients with co-occurring depression and SUD had 13% lower odds of adequate acute-phase psychotherapy and 19% lower odds of continued psychotherapy

“Veterans with depression and substance use disorders receive lower quality depression treatment than those without substance use disorders, despite best practices recommending treating both conditions concurrently,” lead author Lara Coughlin, PhD, said in a statement. “This is true both for medication and psychotherapy, highlighting the need to address comorbid depression in SUD patients and also the importance of thinking about the SUD population for the depression field.”