TY - JOUR
T1 - Prevalence and improvement in psychopathology in opioid dependent patients participating in methadone maintenance
AU - Musselman, Musselman L.
AU - Kell, Michael J.
N1 - Funding Information:
Dominique L. Musselman is affiliated with the Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1701 Uppergate Drive, Atlanta, GA 30322. Michael Jon Kell is affiliated with Private Clinic Atlanta, Atlanta, GA. Correspondence should be addressed to: Michael Jon Kell, Private Clinic Atlanta, 1447 Peachtree St., NE, Suite 900, Atlanta, GA 30309; or: Pharmacokinetics, Ltd, Suite C, 3rd Floor, Regal House, Queensway, P.O. Box 191, Gibraltar. The authors offer special thanks to Cheryl Swofford, MSN, Robin Sherill, LPN and John Cooper, PhD. Funding for this study was provided by Pharmacokinetics Ltd, Suite C, 3rd Floor, Regal House, Queensway, P.O. Box 191, Gibraltar. Pharmacokinetics, Ltd, has no commercial interest in the results of this paper.
PY - 1995/10/12
Y1 - 1995/10/12
N2 - Questions continue in the literature concerning potential cause and effect relationships between opiate dependency and several organically-based psychiatric disorders. For example, does opiate dependency produce secondary anxiety and dysthymic syndromes in otherwise healthy persons? or is narcotics misuse by a patient an attempt to self-medicate pre-existing psychopathology? Does the severity of psychopathologic symptoms decrease with time in treatment? To resolve such questions, we routinely conduct psychiatric evaluations on all opioid dependent patients enrolled into methadone maintenance. In this study, we report upon treatment outcomes for a cohort of 71 patients evaluated for psychopathology upon intake and followed up after being in treatment for a mean time of 24.5 (SD 8.0) months. Based upon objective psychometric testing with confirmatory clinical interview, significant, longitudinal improvements were seen in the symptom severity of anxiety and dysthymia present upon intake evaluation. Personality profiles also improved with treatment. In general, patients presenting with more severe psychopathology required more visits with professional staff in order to stabilize their life situations and personal relationships. No correlation was noted between drug use and severity of psychopathology. Data support the thesis that many opioid dependent patients are self-medicating themselves for preexisting organic psychopathology, most commonly, a combined anxiety-dysthymia syndrome. Improvement seems to occur secondary to the mood stabilizing properties of methadone in disorders thought to be mediated or moderated by endogenous endorphins rather than because of psychotherapeutic interventions.
AB - Questions continue in the literature concerning potential cause and effect relationships between opiate dependency and several organically-based psychiatric disorders. For example, does opiate dependency produce secondary anxiety and dysthymic syndromes in otherwise healthy persons? or is narcotics misuse by a patient an attempt to self-medicate pre-existing psychopathology? Does the severity of psychopathologic symptoms decrease with time in treatment? To resolve such questions, we routinely conduct psychiatric evaluations on all opioid dependent patients enrolled into methadone maintenance. In this study, we report upon treatment outcomes for a cohort of 71 patients evaluated for psychopathology upon intake and followed up after being in treatment for a mean time of 24.5 (SD 8.0) months. Based upon objective psychometric testing with confirmatory clinical interview, significant, longitudinal improvements were seen in the symptom severity of anxiety and dysthymia present upon intake evaluation. Personality profiles also improved with treatment. In general, patients presenting with more severe psychopathology required more visits with professional staff in order to stabilize their life situations and personal relationships. No correlation was noted between drug use and severity of psychopathology. Data support the thesis that many opioid dependent patients are self-medicating themselves for preexisting organic psychopathology, most commonly, a combined anxiety-dysthymia syndrome. Improvement seems to occur secondary to the mood stabilizing properties of methadone in disorders thought to be mediated or moderated by endogenous endorphins rather than because of psychotherapeutic interventions.
UR - http://www.scopus.com/inward/record.url?scp=0028849009&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028849009&partnerID=8YFLogxK
U2 - 10.1300/J069v14n03_05
DO - 10.1300/J069v14n03_05
M3 - Article
C2 - 8555280
AN - SCOPUS:0028849009
VL - 14
SP - 67
EP - 82
JO - Journal of Addictive Diseases
JF - Journal of Addictive Diseases
SN - 1055-0887
IS - 3
ER -