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Using Discrete-Time Survival Analysis to Examine Patterns of Remission from Substance Use Disorder Among Persons with Severe Mental Illness

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Mental Health Services Research

Abstract

Investigators in mental health research are often interested in examining critical events such as onset, relapse, and recovery from illness, including substance use disorders. As data on these critical events are often collected at discrete-time intervals (e.g., weekly, monthly, or yearly), discrete-time survival models are more appropriate than well-known continuous-time methods. In this paper, we present discrete-time survival analysis methods at an introductory level. Using data collected every 6 months from a 3-year study of assertive community treatment in New Hampshire, we show that discrete-time survival models can be used to analyze patterns of remission from substance use disorder among clients with severe mental illness. The main questions investigated are (1) when are remissions more likely to occur? and (2) what variables predict remission? The results indicate that remission is more likely to occur in the first 6 months and in the 3rd year of the study. Gender, age, baseline use of substances, and diagnosis are strong predictors of remission.

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REFERENCES

  • Allison, P. (1982). Discrete-time methods for the analysis of event histories. In S. Leinhardt (Ed.), Sociological methodology 1982. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Allison, P. (1984). Event history analysis. Beverly Hills, CA: Sage.

    Google Scholar 

  • Allison, P. (1995). Survival analysis using the SAS system: A practical guide. Gary, NC: SAS Institute.

    Google Scholar 

  • Cox, D. R. (1972). Regression models and life tables. Journal of the Royal Statistical Society, Series B, 34, 187-202.

    Google Scholar 

  • D'agostino, R., Lee, M., & Belanger, A. (1990). Relation of pooled logistic regression to time dependent Cox regression analysis: The Framingham Heart Study. Statistics in Medicine, 9, 1501-1515.

    Google Scholar 

  • Drake, R. E., McHugo, G. J., Clark, R. E., Teague, G. B., Xie, H., Miles, K. et al. (1998). Assertive community treatment for patients with co-occurring severe mental illness and substance abuse disorder: A clinical trial. American Journal of Orthopsychiatry, 68(2), 201-215.

    Google Scholar 

  • Drake, R. E., Mueser, K. T., & McHugo, G. J. (1996). Clinician rating scalse: Alcohol Use Scale (AUS), Drug Use Scale (DUS), and Substance Abuse Treatment Scale (SATS). In L. I. Sederer & B. Dickey (Eds.), Outcomes assessment in clinical practice (pp. 113-116). Baltimore, MD: Williams & Wilkins.

    Google Scholar 

  • Han, A., & Hausman, J. (1990). Flexible parametric estimation of duration and competing risk model. Journal of Applied Econometrics, 5, 1-28.

    Google Scholar 

  • Hedeker, D., Siddiqui, O., & Hu, F. (2000). Random-effects regression analysis of correlated grouped-time survival data. Statistical Methods in Medical Research, 9, 161-179.

    Google Scholar 

  • Land, K., Nagin, D., & McCall, P. (2001). Discrete-time hazard regression models with hidden heterogeneity: The semiparametric mixed Poisson regression approach. Sociological Methods and Research, 29(3), 342-373.

    Google Scholar 

  • McCullagh, P. (1980). Regression model for ordinal data (with discussion). Journal of the Royal Statistical Society, Series B, 42, 109-142.

    Google Scholar 

  • McHugo, G. J., Drake, R. E., Burton, H. L., & Ackerson, T. M. (1995). A scale for assessing the stage of substance abuse treatment in persons with severe mental illness. Journal of Nervous and Mental Disease, 183, 762-767.

    Google Scholar 

  • Peterson, T. (1991). The statistical analysis of event history. Sociological Methods and Research, 19(3), 270-323.

    Google Scholar 

  • Scheike, T., & Jensen, T. (1997). A discrete survival model with random effects: An application to time to pregnancy. Biometrics, 53, 318-329.

    Google Scholar 

  • Singer, J., & Willett, J. (1993). It's about time: Using discrete-time survival analysis to study duration and the timing of events. Journal of Educational Statistics, 18(2), 155-195.

    Google Scholar 

  • Teachman, J. (1994). Marital status and the duration of joblessness among white men. Journal of Marriage and the Family, 56, 415-428.

    Google Scholar 

  • Tuma, B., & Hanna, T. (1984). Social dynamics: Models and Methods. New York: Academic Press.

    Google Scholar 

  • Willett, T., & Singer, J. (1991). From whether to when: New methods for studying student dropout and teacher attrition. Review of Educational Research, 61(4), 407-450.

    Google Scholar 

  • Willett, J., & Singer, J. (1993). Investigating onset, cessation, relapse, and recovery: Why you should, and how you can, use discrete-time survival analysis to examine event occurrence. Journal of Consulting and Clinical Psychology, 61(6), 952-965.

    Google Scholar 

  • Willett, J., Singer, J., & Martin, N. (1998). The design and analysis of longitudinal studies of development and psychopathology in context: Statistical models and methodological recommendations. Development and Psychopathology, 10, 395-426.

    Google Scholar 

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Xie, H., McHugo, G., Drake, R. et al. Using Discrete-Time Survival Analysis to Examine Patterns of Remission from Substance Use Disorder Among Persons with Severe Mental Illness. Ment Health Serv Res 5, 55–64 (2003). https://doi.org/10.1023/A:1021759509176

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  • DOI: https://doi.org/10.1023/A:1021759509176

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