title: Psychiatric comorbidity, psychological distress, and quality of life in gamma-hydroxybutyrate-dependent patients.
abstract: Understanding the psychiatric state and psychological distress level of patients with gamma-hydroxybutyrate dependence is important to develop effective detoxification and relapse management methods. The aim of the current study was to assess the prevalence among gamma-hydroxybutyrate-dependent individuals of psychiatric comorbidity and psychological distress levels and their association with the individuals' pattern of misuse and quality of life. There were 98 patients tested with the Mini International Neuropsychiatric Interview-plus, the Brief Symptom Inventory, the Depression Anxiety Stress scale, and the EuroQoL-5D as a part of the Dutch gamma-hydroxybutyrate detoxification monitor in 7 addiction treatment centers. Participants were selected from those undergoing inpatient gamma-hydroxybutyrate detoxification treatment between March 2011 and September 2012. Males accounted for 68% of the participants and the average age was 28-years-old. A high rate of psychiatric comorbidity (79%) was detected, including anxiety (current 38%, lifetime 40%), mood (13%, 31%), and psychotic disorders (13%, 21%). The level of psychological distress was significantly higher than the standard outpatient reference group, especially in patients with current psychiatric comorbidity (Brief Symptom Inventory Global Severity Index mean 1.61 versus 1.09, p ≤ 0.01). Increased gamma-hydroxybutyrate misuse (higher dose and shorter interval between doses) was associated with the presence of lifetime psychosis, current mood disorders (rpb= 0.23, p = 0.025), and psychoticism as a symptom of psychological distress. Current anxiety, mood disorders and high psychological stress had a negative effect on participants' quality of life. Gamma-hydroxybutyrate dependence is characterized by serious psychiatric comorbidity and psychological distress, both of which are, in turn, associated with increased gamma-hydroxybutyrate use and a lower quality of life. This needs to be considered during detoxification to avoid complicated withdrawal. Providing treatment for patients' mental health issues is vital for ensuring treatment compliance, avoiding relapse and improving the patients' quality of life.
authors.affiliation: a Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) , Nijmegen , The Netherlands.|b Novadic-Kentron Addiction Care Network , Vught , The Netherlands.
authors.forename: Rama M
authors.initials: RM
authors.lastname: Kamal
authors.affiliation: a Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) , Nijmegen , The Netherlands.
authors.forename: Boukje A G
authors.initials: BA
authors.lastname: Dijkstra
authors.affiliation: a Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) , Nijmegen , The Netherlands.|c Victas, Centre for Addiction Care , Utrecht , The Netherlands.
authors.forename: Gerdien H
authors.initials: GH
authors.lastname: de Weert-van Oene
authors.affiliation: a Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) , Nijmegen , The Netherlands.
authors.forename: Josja A M
authors.initials: JA
authors.lastname: van Duren
authors.affiliation: a Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) , Nijmegen , The Netherlands.
authors.forename: Cornelis A J
authors.initials: CA
authors.lastname: de Jong
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D063487:Prescription Drug Misuse / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D012978:Sodium Oxybate; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology
chemical_list: D012978:Sodium Oxybate
keywords: GHB; GHB dependence; depression; anxiety; gamma-hydroxybutyrate; psychiatric comorbidity; psychological distress; quality of life