Date of Conferral

2-7-2025

Degree

Doctor of Psychology (Psy.D.)

School

Psychology

Advisor

Steven Linnville

Abstract

Individuals with bipolar disorder (BD) require lifelong treatment to manage their symptoms, and many also struggle with comorbid substance use disorders (BD-SUD) that complicate treatment adherence. Despite these challenges, there has been limited research on what factors predict successful treatment adherence in this population. This study was thus conducted to identify key predictors of adherence among individuals with BD-SUD. Several factors were examined, including age, gender, type of substance used at admission, opioid medication-assisted therapy, length of stay in inpatient psychiatric care, type of discharge service, and participation in self-help groups before discharge. The study applied a donut model framework that considers patient-related, medication-related, condition-related, healthcare provider, and socioeconomic factors surrounding the core issue of treatment adherence around this patient group. Using data from the 2020 Substance Abuse and Mental Health Services Administration Mental Health Treatment Episode Data Set, logistic regression was conducted to identify significant predictors. The findings showed that shorter hospital stays and a reduced need for inpatient services such as detoxification or rehabilitation/residential were associated with better treatment adherence after discharge, while other variables showed no significant impact. These results suggest that focusing on hospital stays and discharge services can improve treatment outcomes for individuals with BD-SUD. This approach may also reduce healthcare costs by emphasizing community-based support and ultimately foster positive social change by meeting the needs of this population in a more beneficial manner.

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