title: Depression among entrants to treatment for heroin dependence in the Australian Treatment Outcome Study (ATOS): prevalence, correlates and treatment seeking.
abstract: OBJECTIVE
  To determine the rate of current major depressive disorder (MDD) among entrants to treatment for heroin dependence in three treatment modalities and a non-treatment comparison group; and to ascertain factors associated with depression.
  
  
  METHODS
  Cross sectional structured interview.
  
  
  METHODS
  Sydney, Australia.
  
  
  METHODS
  615 current heroin users: 201 entering methadone/buprenorphine maintenance (MT), 201 entering detoxification (DTX), 133 entering drug free residential rehabilitation (RR) and 80 not in treatment (NT).
  
  
  RESULTS
  Current major depressive episode was reported by 25%. The rates of major depressive disorder ranged from 26% in the treatment groups (23% MT, 25% DTX, 31% RR) to 16% of those not in treatment. Females were more likely to have current major depressive episode (31% versus 21% OR 1.70, 95% CI 1.16-2.48). Factors associated with depression in the treatment groups were post traumatic stress disorder (PTSD), attempted suicide in the last 12 months and severe physical disability. Among the non-treatment group those with depression were also more likely to have PTSD. Women entering treatment were three times more likely to meet criteria for current major depression than women not in treatment. Among men however, the rates were not significantly different.
  
  
  CONCLUSIONS
  Depression is a significant concern among entrants to treatment for heroin dependence. An essential component of treatment should be a consideration of depression, with the provision of appropriate treatment were required.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Teesson
authors.forename: Alys
authors.initials: A
authors.lastname: Havard
authors.forename: Sandra
authors.initials: S
authors.lastname: Fairbairn
authors.forename: Joanne
authors.initials: J
authors.lastname: Ross
authors.forename: Michael
authors.initials: M
authors.lastname: Lynskey
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D016896:Treatment Outcome