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Heroin Addiction and Related Clinical Problems: 2003, 05, 3 (pages: 22 - 36)

Psychiatric severity and treatment response in methadone maintenance treatment programmes: New evidence

Pani P. P., Trogu E., Carboni G., Palla P., Loi A.

Summary: Recent studies have shown that the presence and severity of psychiatric comorbidity in opioid addicts enrolled in methadone maintenance programmes does not interfere with the outcome of treatment evaluated in terms of retention in treatment and heroin use. On this basis we sterted a cohort prospective study, in order to gather information on the impact of psychiatric severity on different outcome indicators of the treatment (retention, craving, use of heroin and cocaine, psychiatric status). The results obtained from the first 78 patients enrolled in the study show no significant differences, in terms of retention in treatment or of heroin amd cocaine use, between patients with high (44% of the cohort) and low (56% of the cohort) psychiatric severity. Regarding psychiatric status, almost all the psychopathological dimensions explored by SCL-90 show a significant reduction in symptoms during the course of the treatment, with a significantly higher improvement in patients with a severe psychopathology. Methadone dose tended to be higher in patients with high psychiatric severity. Moreover these patients had a significantly greater involvement in psychopharmacological treatments. The results of this study are consistent with those of previous ones showing that the severity of psychiatric comorbidity does not substantially alter the efficacy of maintenace methadone treatment