Psychiatric Comorbidity Among Patients on Methadone Maintenance Therapy and Its Influence on Quality of Life
Psychiatric Comorbidity Among Patients on Methadone Maintenance Therapy and Its Influence on Quality of Life
复制标题
DOI：
10.1111/ajad.12317
复制
发表时间：
2016-01-01
影响因子：
3.7
通讯作者：
Bin Habil, Mohamad Hussain
中科院分区：
文献类型：
--
作者：
Fei, Joni Teoh Bing;Yee, Anne;Bin Habil, Mohamad Hussain
背景和目标：合并发生的精神疾病是美沙酮维持治疗（MMT）阿片类药物依赖患者面临的困难之一。本研究旨在评估MMT患者中精神共病的患病率，预测精神共病的因素，并检查精神共病与生活质量之间的关系。在马来西亚的一家三级医院，共有225名接受MMT治疗的男性患者接受了精神病合并症和物质使用障碍的评估，评估使用的是迷你国际神经精神访谈（MINI）和阿片类药物治疗指数（OTI）。他们的生活质量进行了评估，使用世界卫生组织的生活质量（WHOQOL）-BREF.Results：当前和终身非物质使用轴I精神障碍的患病率分别为14.2%和15.6%，而14.7%符合反社会人格障碍的标准。80.9%的患者合并有药物依赖，主要是尼古丁依赖。多变量分析中与非物质使用轴I精神障碍显著相关的因素是使用精神药物、反社会人格障碍和较差的身体健康状况。在控制可能的混杂因素后，患有非物质使用第一轴精神障碍的患者在所有领域（即身体健康、心理、社会关系、环境以及综合生活质量和总体健康状况）的生活质量均显着较差。结论：精神病合并症对生活质量有负面影响。科学意义：精神疾病的检测和提供适当的治疗是必要的，以提高MMT患者的生活质量。
Background and Objectives: Co-occurring psychiatric disorders are among the difficulties faced by patients with opioid dependence on methadone maintenance therapy (MMT). This study aims to assess the prevalence of psychiatric comorbidity among patients on MMT, the factors predicting psychiatric comorbidity and to examine the association between psychiatric comorbidity and quality of life.Methods: A total of 225 male patients on MMT in a tertiary hospital in Malaysia were assessed for psychiatric comorbidity and substance use disorders using the Mini-International Neuropsychiatric Interview (MINI) and Opiate Treatment Index (OTI). Their quality of life was assessed using World Health Organization Quality of Life (WHOQOL)-BREF.Results: The prevalence of a current and lifetime non-substance use Axis I psychiatric disorder was 14.2% and 15.6%, respectively, while 14.7% fulfilled the criteria for antisocial personality disorder. 80.9% had comorbid substance dependence, predominantly nicotine dependence. Factors significantly associated with a non-substance use Axis I psychiatric disorder on multivariate analysis were use of psychiatric medications, antisocial personality disorder and poorer physical health. Patients with a non-substance use Axis I psychiatric disorder had a significantly poorer quality of life in all domains namely physical health, psychological, social relationships, environment as well as combined quality of life and general health after controlling for possible confounders.Conclusion: Psychiatric comorbidity among patients on MMT negatively impacts quality of life.Scientific Significance: The detection of psychiatric disorders and provision of appropriate treatment is needed to improve the quality of life of patients on MMT.