title: Opioid dependence during pregnancy: relationships of anxiety and depression symptoms to treatment outcomes.
abstract: OBJECTIVE
  To examine the relationship of anxiety and depression symptoms with treatment outcomes (treatment discontinuation, rates of ongoing use of illicit drugs and likelihood of preterm delivery) in opioid-dependent pregnant women and describe their use of psychotropic medications.
  
  
  METHODS
  Secondary data analysis from a randomized clinical trial of treatment for opioid dependence during pregnancy.
  
  
  METHODS
  A total of 175 opioid-dependent pregnant women, of whom 131 completed treatment.
  
  
  METHODS
  Symptoms of anxiety and depression were captured with the 15-item Mini International Neuropsychiatric Interview (MINI) screen. Use of illicit drugs was measured by urine drug screening. Preterm delivery was defined as delivery prior to 37 weeks' gestation. Self-reported use of concomitant psychotropic medication at any point during the study was recorded.
  
  
  RESULTS
  Women reporting only anxiety symptoms at study entry were more likely to discontinue treatment [adjusted odds ratio (OR) = 4.56, 95% confidence interval (CI) : 1.91-13.26, P = 0.012], while those reporting only depression symptoms were less likely to discontinue treatment (adjusted OR = 0.14, 95% CI : 0.20-0.88, P = 0.036) compared to women who reported neither depression nor anxiety symptoms. No statistically significant between-group differences were observed for ongoing illicit drug use or preterm delivery. A majority (61.4%) of women reported use of concomitant psychotropic medication at some point during study participation.
  
  
  CONCLUSIONS
  Opioid agonist-treated pregnant patients with co-occurring symptoms of anxiety require additional clinical resources to prevent premature discontinuation.
authors.affiliation: Department of Psychiatry, Vanderbilt University, Nashville, TN, USA. meg.benningfield@vanderbilt.edu
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Benningfield
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
authors.forename: Karol
authors.initials: K
authors.lastname: Kaltenbach
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Heil
authors.forename: Susan M
authors.initials: SM
authors.lastname: Stine
authors.forename: Mara G
authors.initials: MG
authors.lastname: Coyle
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Arria
authors.forename: Kevin E
authors.initials: KE
authors.lastname: O'Grady
authors.forename: Gabriele
authors.initials: G
authors.lastname: Fischer
authors.forename: Peter R
authors.initials: PR
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology*; D002047:Buprenorphine / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008691:Methadone / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000652:urine; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone