Gradual improvement in functioning and mental distress during long-term outpatient SUD treatment - A prospective pre-post study.

Background: Globally, outpatient programs for substance use disorder (SUD) treatment have gained prominence. To assess the broader clinical implications of this trend we investigated shifts in functioning experienced by outpatients undergoing treatment. Methods: We describe the clinical characteristics of a cohort of 93 SUD patients in a Norwegian outpatient treatment clinic. Using paired-samples t-tests, we examined changes in perceived functioning, mental distress, and other clinically relevant outcome variables in a 5-month time interval during the treatment course. Results: We obtained follow-up data for 67 (72%) of the included patients, with no significant difference in patient-related factors between those who completed the treatment course and those who were not assessed at follow-up. Perceived functioning increased significantly from study inclusion (Time 0) (mean 19.8, standard deviation ± 8.8) to its conclusion (Time 1) (24.3, ±9.3; t (66) = 4.5, (95% CI: 2.5-6.5, p < 0.001). We also identified significant improvement in most other measured variables, including mental distress, self-reported sleep quality, restlessness, and obsessive thinking. Substance use-related variables showed a modest, non-significant improvement at T1. Conclusion: During a 5-month course of outpatient treatment, patients' subjective experience of functioning improved significantly. Those with the lowest functioning levels at T0 improved the most. Structured monitoring may be a valuable clinical tool for personalizing intervention, enhancing treatment outcomes, and supporting the clinical decision-making process.

Gender differences and gender convergence in alcohol use over the past three decades (1984-2008), The HUNT Study, Norway.

BACKGROUND: To examine changes in men's and women's drinking in Norway over a 20-year period, in order to learn whether such changes have led to gender convergence in alcohol drinking. METHODS: Repeated cross-sectional studies (in 1984-86, 1995-97, and 2006-08) of a large general population living in a geographically defined area (county) in Norway. Information about alcohol drinking is based on self-report questionnaires. Not all measures were assessed in all three surveys. RESULTS: Adult alcohol drinking patterns have changed markedly over a 20-year period. Abstaining has become rarer while consumption and rates of recent drinking and problematic drinking have increased. Most changes were in the same direction for men and women, but women have moved towards men's drinking patterns in abstaining, recent drinking, problematic drinking and consumption. Intoxication (among recent drinkers) has decreased in both genders, but more in men than in women. The declines in gender differences, however, were age-specific and varied depending on which drinking behavior and which beverage was taken into account. CONCLUSIONS: There has been a gender convergence in most drinking behaviours, including lifetime history of problem drinking, over the past 2-3 decades in this Norwegian general population, but the reasons for this convergence appear to be complex.