the relationship between the level of arterial blood pressure and the development of hypertensive complications is one of the conspicuous difficulties in current concepts of the natural history of essential hypertension. That cardiovascular complications of hypertension are generally more prevalent with the higher levels of blood pressure is recognized. Published data, 1-3 however, invariably include a substantial proportion of cases in which casual blood pressures* were considerably elevated, yet hypertensive complications did not develop, as well as cases in which complications occurred although arterial pressures were only moderately increased. These apparent inconsistencies in the course of the illness lead one to ask how closely are hypertensive complications related to the level of blood pressure? To what extent are the discrepancies between casual blood pressure and clinical
Extending an earlier report of 6-month outcomes, this study reports 12- and 18-month follow-up data for clients (N = 188) entering a therapeutic community drug treatment program who were randomly assigned to day or residential treatment conditions. Outcomes included Addiction Severity Index composite scores and measures of depression, psychiatric symptoms, and social support. Both groups showed significant change over time. The pattern of change indicated decreased problem severity in the 1st 6 months and then maintenance of lowered problem severity. Comparisons between groups indicated greater improvement for residential treatment clients on social problems and psychiatric symptoms but no differences on the remaining outcomes. Although residential treatment may offer some specific advantages, the conclusion here is that improvement among day treatment clients was not significantly different from that of residential treatment clients.
Clients entering a therapeutic community (TC)-oriented drug treatment program were randomly assigned to day or residential conditions and interviewed at 2 weeks and 6 months after admission. Outcomes included Addiction Severity Index composite scores and summary scores for the Beck Depression Inventory, Symptom Checklist-90-R, and a social support scale. Only clients who remained in treatment for at least 2 weeks were included. The mean age of the sample (N = 261) was 32.9 (SD = 6.7 years) and the mean education level was 12.1 years (SD = 1.9 years); 30% were women. Comparison of outcome scores at 6 months between groups, while controlling for baseline values, indicated greater improvement for residential clients on social problems and psychiatric symptoms. The groups were similar on the 8 remaining outcomes, including measures of alcohol and drug problems. Overall, the level of improvement among day treatment clients was not significantly different from that of residential clients.
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