Ascorbic Acid, Alcohol, and Environmental Chemicals a

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73093/1/j.1749-6632.1987.tb23775.x.pd

Komorbiditaet von Opiatabhaengigkeit und anderen psychiatrischen Stoerungen - Praevalenz, Langzeitverlauf und Behandlung Schlussbericht

State of research: Scientific research on the effects of drug addiction treatment reveals that mental disorders and symptoms are very frequent among drug addicts and that treatment success is comparatively low among this group of patients (e.g. McLellan et al. 1983; Rounsaville et al. 1986; Darke et al. 1994). Affective, anxiety and personality disorders are particularly prevalent among consumers of hard drugs (e.g Regier et al. 1990; Ward et al. 1998; Krausz et al. 1998a). Aim of the study: The prospective study on opiate dependants investigates the prevalence of psychiatric comorbidity by an empirical examination of the course of drug addiction. The study is based on the hypothesis that mental disturbances are related to an increased use of drugs and to more unfavourable social conditions and/or increased stress in the social environment. Maturing out of drug dependence and/or rehabilitation is impeded in the case of mental disorders or symptoms. Method: Five surveys with one-year-intervals have been carried out among opiate dependants who were in treatment or continuous contact with addiction health services. The instruments used were mainly standardised instruments such as CIDI, EuropASI, BDI, STAI, SCL-90-R and PDQ-R, and the data were analysed retrospectively and prospectively. Results: The retrospective analysis could establish a clear relationship between a favourable course of the mental symptoms and a better reintegration and decrease of drug use. The prospective analysis concerning the further course of opiate dependence comparing clients without, with mild and with severe psychiatric disorders according to ICD-10 at baseline did not produce the expected correlation. Conclusion: The (lifetime) diagnosis of a psychiatric disorder according to ICD-10 has no prognostic relevance. Only a prospective examination with instruments sensitive to the course of addiction shows the (relatively clear) influence of mental disturbances. The relevance of the results for the treatment of addiction should be discussed in cooperation with the health services, and proposals for an increased consideration of comorbidity problems in addiction treatment should be worked out in workshops and colloquia. (orig.)SIGLEAvailable from TIB Hannover: F00B926 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung und Forschung (BMBF), Bonn (Germany)DEGerman