t A Prospective Study of Integrated Outpatient Treatment for Substance-Abusing Sch izophren ic Patients David J. Hellerstein, M.D. Richard N. Rosenthal, M.D. Christian R.Miner, Ph.D. Forty-seuen psycbiatric inpatients utitb concurrent RDC-diag- nosed scbizopbrenia and psychoactiue substance use disorclers were randomly assigned to one of two outpatient treatment programs: 1) integrated psychiatric ancl substance abuse treat- ment; or 2) non-integrated treatnxent. Patients abused cocaine, alcobol, and marijuAna, uitb ouer twoibirds using all tbree dntgs. At 4 montbs, 16 of Z3 patients (69.60/o) in integrated treatment remained in treatment us. 9 of 24 (37.5o/o) in the nonintegrated treatment. Rehospitalization d.id not dffir be- lueen groups, but treatment nonstarters bad significantly more days in tbe bospital than tbose ubo began treatment. At B months, addiction and psycbicttric seuerity decreased signifi- cantly for patients remaining in treatment. Engagcment in integrated outpatient treatftTent may decrease rebospitaliza- tion, r,tnd lessen psycbiatric and substance abuse seuerity. (American Journal on Addictions 1995; 4,3H2) espite increased recognition of the high frequency of concurrent schizophrenic and psychoactive substance use disorders (PSUD),l-4 there are few data regarding the effectivenessof outpatient treatment for pa- tients comorbid for both disorders (PSUD/S patients). Uncontrolled studiess6 have sug- gested that many patients with both disor- ders may be engaged in treatment by outpatient gro.up therapy that integratessub- stanceabuse and psychiatric approaches. In a pilot study of once-per-week outpatient group treatment for a cohort of .substance- abusing schizophrenic patients,5 we found that rehospitalization was decreased signifi- cantly among group members, who aver- aged38.2 days per year in the hospital in the year prior to treatment and only 7.8 days per ReceivedDecember 1, 1993; revised May 24, 1994; accepted June 9, 1994. From the Department of Psychiatry, Beth Israel Medical Center, New York, NY. Address correspondenceto DavidJ. Hellerstein, M.D., Physician-in-Charge, Psychiatric Outpatient Services, Beth Israel Medical Center, lst Avenue and 16th Street, New York, NY 10003. Copyright @ 1995 The American Academy of Psychiatrists in Alcoholism & Adclictions. THE AMERICAN IOURNAL ON ADDICTIONS 33