Assessing efficiency of treatment practices in adolescents diagnosed with substance use disorder

Aim: Substance abuse has been an increasingly common entity among youth, that has turned into one of the major concerns for almost all countries in the world. Accordingly, it was also reported that there has been an observed increase regarding substance abuse recently, both in our country and worldwide. As teenagers constitute an important risk group regarding onset of substance abuse, it would be much more important to recognise the process and treat it in an appropriate manner, especially for this group. Specialized treatment centers serving specifically this issue is highly warranted. Scientific research to be conducted within Child and Adolescent Substance Dependency Treatment Centers (CASDTC) would provide guidance to determine risk groups and take precaution and prevention. The aim of this study was to explore efficacy of treatment applied in one of the rare CASDTCs in Turkey along with functional assessment of cases, compare efficacy of inpatient treatment with outpatient treatment, and finally, hope to contribute to relevant literature that included scarce scientific data, in our country. Methods: Thirty adolescents aged between 12-18 years old that were diagnosed with SUD (substance use disorder) according to DSM-5 diagnostic criteria, and being followed up in the outpatient unit of Child and Adolescent Substance Dependency Treatment Center (CASDTC) of Tepecik Research and Training Hospital and 30 adolescents that had been treated in the inpatient unit of the same center at the time of study were included, along with their families. Thirty adolescents that had applied to Pediatrics Unit of Dokuz Eylul University Hospital for routine check up, that did not have any active psychiatric diagnosis or symptoms comprised the control group, along with their parents. Measurements were carried out at two different time frames, where efficacy of both outpatient and inpatient treatment were assessed in the beginning of treatment and following compleiton of the 8-week treatment programme. At T1, case and control groups were reaassesed, while at T2, re-evaluations were carried out with the case group that had been treated in the inpatient unit and the other case group that had participated in the outpatient treatment programme. In order to determine comorbid diagnoses with SUD at T1, Kiddie Schedule for Affective Disorders and Schizophrenia- Present and Lifetime Version (K-SADS-PL) was applied to each adolescent and his/her parent. Children's Global Assessment Scale was used to evaluate overall functioning of participants at T1-T2. Cases and parents were asked to complete Family Assessment Device (FAD) to evaluate family functions; Strengths and Difficulties Questionnaire (SDQ) and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) to assess general psychiatric symptoms. HoNOSCA scales that were scored by the treatment team at T1 and T2, for cases that received inpatient treatment have also been evaluated. Results: Initial evaluation of data collected from cases and controls revealed significantly lower CGAS scores in the case group with individuals diagnosed with SUD, compared to those in the control group. On the contrary, FAD subscale scores, SDQ and HoNOSCA total scores and subscale scores were significantly higher in the case group, compared to controls. As for postreatment assessments of the group diagnosed with SUD following 8-week treatment programme; it was seen that the increase in CGAS scores of both groups, and decline in the total and subscale scores of SDQ and HoNOSCA instruments were statistically significant; and this measurable improvement of overall functioning and psychiatric symptoms was in significantly higher levels among participants that had been treated in the inpatient unit, compared to those that had received treatment in the outpatient settings. Conclusion: Results of our study suggested better overall functioning, significant improvement of psychiatric symptoms among adolescents diagnosed with SUD, following their participation in an 8-week treatment programme; and the improvement was much better in those that had been treated in the inpatient unit. Further studies with long-term follow up data in these populations are warranted and we believe, shall contribute greatly to the relevant literature. Keywords: Substance Use Disorder, treatment, functioning