title: Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study.
abstract: Opioid-dependent patients show a high rate of psychiatric comorbidities. The prevalence and characteristics of patients with dual diagnosis have not been well established in Spanish opioid agonist treatment (OAT) programmes. Thus, 621 opioid-dependent patients enrolled in OAT programmes were assessed, using the EuropASI questionnaire, for psychiatric comorbidities, which were detected in 67% of patients (anxiety 53%, mood disorders 48%, sleep disorders 41%, substance-related disorders 36%). In addition, compared with patients without a dual diagnosis, patients with dual pathology were significantly older, used benzodiazepines and cannabis in significantly greater percentages, and showed significantly more frequent infectious and non-infectious comorbidities, worse overall working status, a lower proportion of drivers and higher levels of severity regarding medical, employment, alcohol, legal, family and psychological issues. Therefore, the data showed a very high prevalence of psychiatric comorbidity in opioid-dependent patients receiving OAT in Spain and several problems frequently associated with patients with dual diagnosis. Physicians treating opioid-dependent patients should be aware of these facts to correctly identify and manage patients with a dual diagnosis.
authors.affiliation: Addition and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: croncero@vhebron.net.
authors.forename: Carlos
authors.initials: C
authors.lastname: Roncero
authors.affiliation: Addition and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Barral
authors.affiliation: Addition and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Rodríguez-Cintas
authors.affiliation: Addition and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Pérez-Pazos
authors.affiliation: Addition and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Martinez-Luna
authors.affiliation: Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Casas
authors.affiliation: Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institute of Neuropsychiatry and Addiction, Hospital del Mar, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Torrens
authors.affiliation: Addition and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Lara
authors.initials: L
authors.lastname: Grau-López
mesh_terms: D000328:Adult; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Comorbidity; Dual diagnosis; EuropASI questionnaire; Methadone; Opioid agonist treatment; Opioid dependence; Psychiatric