Depression in methadone maintenance treatment patients: Rate and risk factors
Depression in methadone maintenance treatment patients: Rate and risk factors
复制标题
DOI：
10.1016/j.jad.2006.09.017
复制
发表时间：
2007-04-01
影响因子：
6.6
通讯作者：
Adelson, Miriam
中科院分区：
文献类型：
--
作者：
Peles, Einat;Schreiber, Shaul;Adelson, Miriam
背景：在美沙酮维持治疗(MMT)中，抑郁在海洛因依赖者中广泛存在。方法：采用横断面研究方法，采用汉密尔顿抑郁量表(21-HAM-D)和简明精神病评定量表(BPRS)对90例MMT患者进行抑郁评定。为了研究药物滥用可能导致抑郁的可能性，在进入研究前的1个月内，对尿样中的阿片类药物、可卡因代谢物(苯甲酰ecGonine)、苯二氮卓类、大麻、苯丙胺和美沙酮代谢物进行了检测：如果至少有一个样本阳性，则定义为阳性。结果：21-HAM-D和简明精神病评定量表的得分显著相关(Pearson R=0.76，p<；0.0005)。50%的人被发现患有抑郁症(21-HAM-D，得分18)。与疗程无关，MMT治疗的15名新患者得分(5.1+/-5.7)高于连续治疗患者(17.7+/-6.2，p<；0.0005)。有Axis I精神疾病诊断的51例患者得分较高(18.9±-5.7vs.11.4+/-7.9p<；0.0005)，74例滥用和/或使用苯二氮卓类药物(16.3+/-7.4vs.11.7+/-8，p=0.03)，36例开出一种以上药物(17.5+/-7.3vs.14.2+/-7.7，p=0.05)。女性(N=40)得分低于男性(17.6+/-7比14.1+/-7.9，P=0.03)，尤其是孕期入院治疗的患者(20.2+/-4.1)。限制：患者滥用药物和停药会扭曲评估，导致对抑郁的错误分类。结论：抑郁症的主要危险因素是MMT、女性、任何DSM-IV轴精神疾病诊断、服用任何精神药物、滥用或使用处方BDZ、美沙酮剂量和GT；120 mg/d。(C)2006爱思唯尔B.V.保留所有权利。
Background: Depression is widely prevalent among former heroin addicts in methadone maintenance treatment (MMT). The risk factors for depression among MMT patients that have not been well characterized, was studied.Methods: In a cross-sectional study (January, 2004-August, 2005), 90 MMT patients were evaluated for depression by the 21-item Hamilton Rating Scale for Depression (21-HAM-D) and the Brief Psychiatric Rating scale (BPRS). To study possible induction of depression by drug abuse, urine samples tested for, opiates, cocaine metabolite (benzoylecgonine), benzodiazepines (BDZ), cannabis (THC), amphetamines and methadone metabolite during I month preceding study entry: a drug was defined as being positive if at least one sample was positive.Results: The 21-HAM-D and BPRS scores were significantly correlated (Pearson R=0.76, p < 0.0005). Fifty percent were found to be suffering from depression (21-HAM-D, scored 18). Fifteen new patients in MMT had better scores (5.1 +/- 5.7) than continuous patients (17.7 +/- 6.2, p < 0.0005), independent of treatment duration. Higher scores were in 5 1 patients with any Axis I psychiatric diagnosis (18.9 +/- 5.7 vs. 11.4 +/- 7.9, p < 0.0005), 74 abusing and or using prescribed BDZ (16.3 +/- 7.4 vs. 11.7 +/- 8, p=0.03), and 3 6 prescribed more than one type of medication (17.5 +/- 7.3 vs. 14.2 +/- 7.7, p=0.05). Females (N=40) bad poorer scores than males (17.6 +/- 7 vs. 14.1 +/- 7.9, p=0.03), especially 12 admitted into treatment while pregnant (20.2 +/- 4.1).Limitation: Patient drug abuse and withdrawal could distort evaluation and lead to misclassification of depression.Conclusion: The major risk factors for depression were already being in MMT, female gender, any DSM-IV Axis I psychiatric diagnosis, taking any psychotropic medication, abuse or using prescribed BDZ, and methadone dose > 120 mg/day. (c) 2006 Elsevier B.V. All rights reserved.