Elsevier

Addictive Behaviors

Volume 23, Issue 6, November–December 1998, Pages 767-783
Addictive Behaviors

Comorbidity of opiate dependence and mental disorders

https://doi.org/10.1016/S0306-4603(98)00099-9Get rights and content

Abstract

In a 5-year-follow-up study of 350 opiate addicts in contact with a drug help system in Hamburg, 272 clients (78%) were interviewed a second time after 1 year. The objective of the study was to examine the correlation between mental disorders and drug consumption and its relationship to clients’ general life situation. In the majority of the opiate addicts, a pattern of polydrug consumption was observed, but the amount of drugs consumed was clearly lower after 1 year. In the initial survey, a mental disorder according to ICD-10 could be diagnosed for 55% of the sample. Among groups formed by the severity and course of mental disorders or their symptoms, a significant correlation was observed, particularly at the time of follow-up, between the extent of drug consumption and the course of the mental disorder. Other areas, like physical health or social problems/conflicts, were also related to comorbidity (i.e., heavy drug consumption and/or mental disorder). These interrelationships should be taken into account in treatment, care and guidance to increase the prospects for successful treatment.

Section snippets

Method

Two evaluations have now been carried out as part of a prospective follow-up study. The initial evaluation took place during the second half of 1995. A total of 350 opiate addicts in treatment or in regular contact with drug advice centres were interviewed. The first follow-up 1 year later succeeded in reaching 272 of the sample (78%). A further three follow-ups took place at 1-year intervals during the remainder of the study.

Survey group

As mentioned above, 78% of clients were contacted again for follow-up (N = 272). Eleven clients had died during the year between interviews (3%). In four cases, the cause of death was known (overdose = 2, suicide = 1, unnatural causes = 1); another client probably died of a stroke, and two suffered from AIDS. Sixteen persons could not be traced at follow-up (5%) and two clients had been deported (1%). Ten clients (3%) said they did not want to take part in the interview at present but might

Discussion

Among 272 opiate addicts currently or previously in contact with the Hamburg drug help system, the lifetime prevalence of an additional psychiatric disorder under ICD-10 is 55%. These disorders are mostly in the areas of neurotic, strain and somatoform disorders (F4) and affective disorders (F3). These results are comparable to prevalence rates reported in other international studies (e.g., Hendriks 1990, Regier et al. 1990). Personality disorders for which diagnosis is of generally poor

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