Effects of gender and diagnosis on addiction history,treatment utilization,and psychosocial functioning among a dually-diagnosed sample in drug treatment

There has been increased recognition of the clinical treatment needs of patients with co-occurring mental and substance use disorders and the heterogeneity of this group with regard to types of substances used and mental disorders. This article examines differences between men and women diagnosed with mood or psychotic disorders at admission to residential drug treatment, specifically regarding their addiction history, treatment history, perceived service needs, and psychosocial functioning. Males initiated drug use at a younger age and had higher levels of dependence on alcohol, cannabis, and opioids. There were no differences among groups in treatment history, motivation, or initiation. Males had higher rates of being under legal supervision and engaging in property crime, whereas females had higher rates of prostitution. Females had greater needs for family- and trauma-related services, and females with psychotic disorders had the highest needs for basic services. There were no differences among groups in barriers to treatment, quality of life, self-efficacy, or family support. Individuals with psychotic disorders had more symptoms of psychological distress; females had higher rates of posttraumatic stress disorder. Differences among dually-diagnosed individuals related to gender and diagnosis need to be considered in treatment planning and in matching services to patient needs.