Quality of life in a community sample of young cocaine and/or heroin users: the role of mental disorders

Abstract

Purpose: Drug addiction and psychiatric disorders are frequently concomitant; however, few studies have investigated the impact of psychiatric disorders other than substance use disorder (SUD) on Health-Related Quality of Life (HRQoL) in drug users not in treatment. We studied the association of psychiatric disorders other than SUD with HRQoL in a street-recruited sample of cocaine and/or heroin users.Methods Cross-sectional study in 287 young users of cocaine and/or heroin in Barcelona, Spain. HRQoL was assessed with the Nottingham Health Profile (NHP). Patterns of drug use and mental disorders were assessed using theSpanish version of the Psychiatric Research Interview for Substance and Mental Disorders-IV (PRISM); and degree of dependence through the Severity of Dependence Scale (SDS). The association of mental disorders with HRQoL was assessed through a Tobit regression analysis.Results: The overall NHP score was 23.9 (SD=20.5, range 0 to 91.7). Sixty-one percent of the sample had two or more SUDs; 22% had at least one non-SUD Axis I disorder (anxiety, mood, psychotic oreating disorder) and 27.2% had a Borderline Personality Disorder (BPD)and/or Antisocial Personality Disorder. Variables negatively associated with the global NHP score were psychosis (transformed beta coefficient: 15.23; 95% Confidence Interval [CI]:4.48-25.97), BPD (9.55; 95%CI:2.95-16.15), severity of dependence (8.12; 95%CI:3.37-12.87), having two or more SUDs (for two or three SUDs: 6.83; 95%CI:2.08-11.59) (>3 SUDs: 7.70; 95%CI:1.72-13.68) and the intravenous use of some substance (10.20; 95%CI:6.00-14.40).Conclusions: HRQoL among street-recruited illegal substance users was impaired, particularly among those with psychiatric comorbidity, psychosis and Borderline Personality Disorder being especially relevant.The field work was financed by Fundación para la Investigación y la Prevencio´n del Sida en España (Fipse 486 3035/99) and Plan Nacional Sobre Drogas (PNSD 2001 and 2004). The analysis and writing of this article was made possible by grants EPY-020/029 (ISCIII) and RD06/0001/1018, and (RTA) RD12/0028/0018 and RD12/0028/0009. Further financial support was provided by the Age`ncia de Gestió d’Ajuts Universitaris i de Recerca (AGAUR 2009 SGR 718). Albert Sánchez-Niubò was supported by the Instituto de Salud Carlos III Grant No. A08/00214