Effects of Psychiatric Comorbidity on Treatment Outcome in Patients Undergoing Diamorphine or Methadone Maintenance Treatment

Background: Comorbid psychiatric disorders among opioid-dependent patients are associated with several negative outcome factors. However, outcomes of maintenance treatment have not been sufficiently established, and no evidence is available with respect to heroin-assisted treatment (HAT). Methods: F...

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Bibliographic Details
Authors: Schäfer, Ingo, Eiroá Orosa, Francisco José, Verthein, Uwe, Dilg, Christoph, Haasen, Christian, Reimer, Jens
Format: article
Status:Versión aceptada para publicación
Publication Date:2010
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/120731
Online Access:https://hdl.handle.net/2445/120731
Access Level:Open access
Keyword:Comorbiditat
Desintoxicació de les drogues
Metadona
Heroïna
Comorbidity
Drug detoxification
Methadone hydrochloride
Heroin
Description
Summary:Background: Comorbid psychiatric disorders among opioid-dependent patients are associated with several negative outcome factors. However, outcomes of maintenance treatment have not been sufficiently established, and no evidence is available with respect to heroin-assisted treatment (HAT). Methods: For patients in the German heroin trial outcome measures were analyzed for HAT versus methadone maintenance treatment (MMT) both for patients with and without a comorbid diagnosis according to CIDI. Results: 47.2% of the sample had at least one comorbid psychiatric diagnosis, mainly neurotic, stress-related or somatoform (F4) or affective (F3) disorders. HAT had a better outcome than MMT concerning improvement of health and reduction of illicit drug use in both comorbid and non-comorbid patients, but weaker effects were found in the comorbid group. Conclusions:The better outcome of HAT also in comorbid patients suggests that psychiatric comorbidity should be an inclusion criterion for HAT. The weaker advantage of HAT may be due to pharmacological or methodological reasons.

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