American Journal of Psychiatry Audio

May 2021: Quality of Depression Care for Patients With Comorbid Substance Use Disorder


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Executive Editor Michael Roy speaks with Lara N. Coughlin, Ph.D., and Lewei Allison Lin, M.D., M.S., about their article on the provision of guideline-concordant depression treatment to patients with and without substance use disorders.

Dr. Lara Coughlin is an assistant professor in the Department of Psychiatry and an adjunct assistant professor of psychology at the University of Michigan. She is also a licensed clinical psychologist. Her research aims to find new ways to use behavioral economic frameworks to improve outcomes among individuals with substance use disorders. In particular, she is interested in decision making around health behaviors, such as choosing between sooner and smaller rewards, like substance use, and delayed and larger rewards, like overall health or career development. Her current work looks at the delivery and evaluation of care for underserved and rural populations.

Dr. Allison Lin is an addiction psychiatrist, an assistant professor in the Department of Psychiatry at the University of Michigan, and a research scientist in the Department of Veterans Affairs Ann Arbor Healthcare System.

  • How the authors became interested in their areas of research [2:28]
  • How often does depression co-occur with other disorders? [5:05]
  • Current recommendations or best practices for the treatment of these conditions [5:33]
  • Objective of the study [6:55]
  • Description of study participants [7:27]
  • Measures used to collect and analyze data [9:15]
  • Main results of the study [11:20]
  • Were there significant differences between disorders with respect to receipt of appropriate treatment? [12:10]
  • Did any demographic characteristics, medical comorbidities, or other variables affect the findings? [13:25]
  • Other notable or surprising results [14:03]
  • Do the findings of the study extend to patients in the general population? [14:50]
  • Study limitations [15:28]
  • Patient or structural factors that may contribute to inequity in guideline-concordant care [16:13]
  • How can we improve depression care for patients with comorbid substance use disorders? [19:01]
  • Key points that researchers, clinicians, and other mental health professionals should take away from the article [22:12]
  • Recommendations for further research in this area [23:32]

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