title: Depression among needle exchange program and methadone maintenance clients.
abstract: The objective of this study was to compare the prevalence of major depression in two cohorts of injection drug users, those enrolled in a Rhode Island Methadone Maintenance Treatment Program (MMTP) and those enrolled in a Rhode Island Needle Exchange Program (NEP) using cross-sectional interviews. Symptomatic and duration criteria for major depression in the last 6 months were identified using the Structured Clinical Interview for DSM-III-R (SCID). Among 528 persons interviewed, 54% of those in NEP and 42% of those in MMTP met criteria for major depression. Using multivariate logistic regression, women (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.7-3.7), persons with alcohol use disorders (OR 1.7; 95% CI 1.1-2. 7), and persons without a current partner (OR 1.8; 95% CI 1.2-2.6) were more likely to be depressed controlling for age, race, education and HIV status. Persons enrolled in MMTP were less likely to be depressed (OR 0.6; 95% CI 0.4-0.8) than NEP. Higher rates of depression were found among NEP attendees than among those enrolled in MMTP. Mental health referrals should be part of the growing number of needle exchanges in the United States.
authors.affiliation: Division of General Internal Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Brienza
authors.forename: M D
authors.initials: MD
authors.lastname: Stein
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.forename: A
authors.initials: A
authors.lastname: Gogineni
authors.forename: M
authors.initials: M
authors.lastname: Sobota
authors.forename: J
authors.initials: J
authors.lastname: Maksad
authors.forename: P
authors.initials: P
authors.lastname: Hu
authors.forename: J
authors.initials: J
authors.lastname: Clarke
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*
chemical_list: D008691:Methadone