Effect of Psychiatric Severity on the Outcome of Methadone Maintenance Treatment

Abstract

While psychiatric comorbidity has been shown to produce a negative impact on the outcome of opioid use disorders, longitudinal studies carried out in the context of methadone maintenance treatment programs (MMTP) to evaluate outcomes strictly linked to methadone efficacy have not demonstrated a similar negative influence. To verify whether results obtained considering psychopathology in terms of formal psychiatric diagnoses were replicated when assessing psychopathology in terms of global psychiatric severity, a retrospective cohort study was designed. 259 patients commencing methadone maintenance treatment were divided into two groups on the basis of SCL-90 severity score and compared for retention in treatment, toxicological urine test results and psychological/psychiatric status throughout a one year period of observation. The results of the study suggest that patients in MMTP with high psychiatric severity are not characterized by a lower retention in treatment or higher substance use than those with low psychiatric severity. Moreover, during treatment high severe psychiatric patient status appears to improve significantly for all psychological/psychiatric dimensions explored by SCL-90. These results are consistent with those obtained in previous studies on the efficacy of MMTP, comprehensive of psychiatric care, irrespective of the severity of psychopathology exhibited by patients at the beginning of treatment.

Association of Nerve Growth Factor and Vascular Endothelial Growth Factor A with Psychometric Measurements of Opiate Dependence: Results of a Pilot Study in Patients Participating in a Structured Diamorphine Maintenance Program

“…Therefore, inflammatory processes may have influenced the serum levels of both growth factors investigated in this study, which we did not control. Moreover, as is typical for opiate-dependent patients treated with DAM [28,29], patients enrolled in this study were not only treated with DAM but also with further substances like methadone or antidepressants. Urine samples revealed that the patients also consumed further psychotrophic substances like benzodiazepines and amphetamines.…”

Increased Somatic Morbidity in the First Year after Leaving Opioid Maintenance Treatment: Results from a Norwegian Cohort Study

“…However, in a recent study, severity of psychiatric comorbidity was not shown to be associated with lower retention in treatment or higher substance use during treatment [28]. The influence of mental disorders on acute somatic morbidity would have been of interest, but these data were not available in this study.…”

Efectividad a largo plazo de los tratamientos de mantenimiento con metadona en personas con adicción a derivados opiáceos

“…La prevalencia de comorbilidad psiquiátrica entre los sujetos dependientes de opiáceos que acuden a tratamiento varía entre 44% y 93%, siendo los trastornos depresivos y de ansiedad y los trastornos de personalidad antisocial y límite los más frecuentes (Mateu, Astals y Torrens, 2005). Un estudio reciente, señala como aquellos pacientes con trastornos psiquiátricos más graves mejoran significativamente en las dimensiones psicológicas y psiquiátricas del SCL-90 durante el tratamiento con metadona (Pani et al, 2011).…”