@article{10272/27968,
year = {2026},
url = {https://hdl.handle.net/10272/27968},
abstract = {Background: Sex differences in substance use disorder (SUD) treatment outcomes remain unclear; protocols focused on male prevalence may overlook female-specific needs. This study tested interactions among sex, the telescoping effect, and comorbid profiles in outcomes.
Methods: Retrospective multisite electronic health record study (N = 4818) of patients with co-occurring disorders. Interaction regressions and latent class analysis tested sex moderation of links between years of substance use (telescoping) and outcomes within SUD and co-occurring diagnostic groups.
Results: Slower progression from substance use onset to diagnosis was associated with lower readmission likelihood at 3 years in males than females; similar patterns appeared at 18 and 24 months for alcohol dependence and at 18 months for co-occurring mood disorders. Six comorbid classes were identified (feature-based labels): behavioral dysregulation (Class 1), anxious distress (Class 2), adolescence–cannabis (Class 3), emotional–interpersonal dysregulation (Class 4), affective–alcohol (Class 5), and reality distortion (Class 6). Only Classes 2 and 4 showed the telescoping effect. Latent-class moderation revealed males in Classes 1 and 3 had higher readmission over 3 years, whereas females in Class 4 had lower adherence to scheduled appointments and higher predicted readmissions across all follow-ups. Females in Class 6 showed better appointment adherence than males.
Conclusions: Telescoping and sex differences may contribute to higher readmission in females, particularly with alcohol dependence and mood or personality disorders. Males with impulse-control or childhood disorders may require more post-treatment care. Sex-specific interventions and moderation/latent class approaches may improve targeting.},
organization = {This work was supported by the grant COMPARA project, grant P20_00735; Andalusian Research, Development and Innovation Plan; co-funded by the European Regional Development Fund [ERDF/EU] and the Junta de Andalucía, Spain.},
publisher = {Elsevier},
title = {Could the telescoping effect and comorbidity with substance use disorders account for sex differences in the processes and therapeutic outcomes? A latent-class moderation analysis},
doi = {10.1016/j.drugalcdep.2026.113062},
author = {Dacosta Sánchez, Daniel and Mancheño Velasco, Cinta and Narváez Camargo, Marta and Lozano Rojas, Óscar Martín},
}