Significance of comorbidity for the long-term course of opiate dependence.
OBJECTIVE
Studies on drug dependence show a high prevalence of comorbidity with additional mental disorders. Comorbidity patients also show more poly-substance use and other psychosocial problems. This study analyzed the importance of comorbidity for the long-term course of opiate dependence.


METHODS
350 opiate-dependent patients were examined at yearly follow-ups over 4 years using the EuropASI for the assessment of drug-related problems and the CIDI for diagnostic of psychiatric disorders. 196 patients were reached at final follow up (56%).


RESULTS
Of the patients reached at final follow-up, 30% had severe, 29% mild and 41% no clinically relevant disorders at baseline. However, the linear relationship at baseline--the more severe the disorder, the greater the impairment through drug-related problems--was not present at final follow-up. The results show that lifetime diagnosis of mental disorder had no prognostic relevance for the long-term course of drug dependency.


CONCLUSIONS
The assumption that opiate users with an additional mental disorder are more vulnerable in their course of addiction could not be confirmed.
Verthein
Uwe
U
Centre for Interdisciplinary Addiction Research of Hamburg University (CIAR), Hamburg, Germany. verthein@sozialwiss.uni-hamburg.de
Degkwitz
Peter
P
Haasen
Christian
C
Krausz
Michael
M
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D008609:Mental Status Schedule; D011379:Prognosis; D011788:Quality of Life; D012917:Social Adjustment; D016320:Substance Abuse Treatment Centers