Long-term outcomes of treatment-resistant heroin addicts with and without DSM-IV axis I psychiatric comorbidity (dual diagnosis).
OBJECTIVE
The aim of this study was to compare the long-term outcomes of treatment-resistant heroin addicts with and without DSM-IV axis I psychiatric comorbidity (dual diagnosis).


METHODS
129 heroin addicts who also met criteria for treatment resistance, 66 with one or more DSM-IV axis I psychiatric diagnosis (DD patients), and 63 without DSM-IV axis I psychiatric comorbidity (NDD patients) were monitored prospectively (6 years on average, min. 1, max. 9) along a methadone maintenance treatment program (MMTP).


RESULTS
The rates for survival-in-treatment were about 50% for NDD patients and about 70% for DD patients. After 4 years of treatment onwards, such rates tended to become stable. DD patients showed better outcome measures than NDD patients. A significantly higher methadone dose was needed to have DD patients stabilized.


CONCLUSIONS
Contrary to expectations, treatment-resistant patients with psychiatric comorbidity showed a better long-term outcome than treatment-resistant patients without psychiatric comorbidity.
Maremmani
Icro
I
Vincent P. Dole Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Italy. maremman@med.unipi.it
Pacini
Matteo
M
Lubrano
Sonia
S
Perugi
Giulio
G
Tagliamonte
Alessandro
A
Pani
Pier Paolo
PP
Gerra
Gilberto
G
Shinderman
Marc
M
D000328:Adult; D002391:Catchment Area, Health; D015331:Cohort Studies; D015897:Comorbidity; D003710:Demography; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D004351:Drug Resistance; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006556:Heroin Dependence / Q000175:diagnosis* / Q000534:rehabilitation*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012153:Retention, Psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D017211:Treatment Failure
D009294:Narcotics; D008691:Methadone