Characteristics and outcome of methadone maintenance treatment (MMT) patients with depression

Abstract

Introduction

Comorbidity of depression and opioid addiction is highly prevalent, but their outcome in MMT is not consistent.

Objectives

To compare between depressed and non-depressed MMT patients.

Methods

Hamilton depression scale scores (taken during a psychiatric assessment) were studied among MMT patients on admission or during treatment (cutoff for depression > 18).

Results

A total of 498 MMT patients were studied. Depression proportion was 22.5%, and 23.2% among 263 who were studied on admission; the depressed vs. non-depressed on admission did not differ in female proportion (19.7% vs. 25.6%), age of admission (43.2 ± 10.4), opiate use onset (21.8 ± 6.3) and education years (9.5 ± 2.8), but had higher proportion of cocaine (55.7% vs. 35.1%, P = 0.005), and benzodiazepine abuse (73.8% vs. 58.4%, P = 0.04). Retention was high and similar (80.3 vs. 82.9% P = 0.7) and of those who stayed one year, cocaine and benzodiazepine were still higher among the depressed patients (cocaine: 43.8% vs. 23.2%, P = 0.03; BDZ: 61.2% vs. 40%, P = 0.01). Compared to the non-depressed, among all study group (n = 498) the depressed patients presented higher proportion of rape history (25% vs. 9.5%, P = 0.001), of suicide attempts (43.8% vs. 25%, P = 0.001) with only a trend of shorter cumulative retention in MMT of mean 9.4y (95% CI 7.8–10.7) vs. 11.5 (95% CI 10.5–12.5, P = 0.07).

Conclusion

Despite cocaine and benzodiazepine abuse on admission, depressed succeeded similarly to the non-depressed in the first year retention in treatment. Intervention is recommended since admission, as their long-term retention seems to be shorter, later on, and their ability to discontinue cocaine and benzodiazepine abuse is clearly hampered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.