Abstract Objective: Comorbidity of depression among individuals with opioid addiction is highly prevalent, but their outcome in methadone maintenance treatment (MMT) is not well determined. Methods: Characteristics and outcomes (retention until December 2017) of newly admitted and already (5.5 ± 4 years) in MMT patients with available Hamilton Depression Rating Scale (HAM-D) scores on admission were studied. Results: During psychiatric intake on admission, 70 (21.2%) of 330 patients were diagnosed with high depressive symptoms beyond the cutoff (HAM-D scores ≥ 18). Depressed and nondepressed groups had a similar proportion of females (20% and 23.8%) and age at admission (43.0 ± 10.5 and 43.7 ± 10.4 years), but the depressed group had higher Brief Psychiatric Rating Scale (BPRS) scores (21.4 ± 8.6 vs. 7.0 ± 7.3, respectively; p < .0005), a higher proportion of minority (non-Jewish faith; 28.6% vs.15.4%; p =.02), and a higher proportion of positive urine screening results for cocaine (55.7% vs. 34.4%; p = .001) and for benzodiazepines on admission (74.3% vs. 57.5%; p = .01). Retention after 1 year was similar (79% and 80.7%), but depressed patients had higher rates of cocaine (40.8% vs. 25.5%; p = .05) and benzodiazepine use (59.2% vs. 41.8%; p = .04) and a shorter cumulative retention (5.6 years, 95% confidence interval [CI; 4.3, 7.0]) than the nondepressed patients (6.8 years, 95% CI [6.1, 7.5]; p = .05). Of the 263 evaluated while already in MMT, 23.5% were depressed, characterized with more females (43.5% vs. 23.4%) and with a history of rape (34.5% vs. 7.6%). Conclusions: Newly admitted depressed and nondepressed patients succeeded similarly in the first year retention in treatment, despite their cocaine and benzodiazepine co-abuse. The depression was characterized with females and with rape history in those who were already in MMT. Adequate intervention is recommended for both depressed groups to improve long-term retention and outcome.

中文翻译：

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入院时有高度抑郁症状的患者接受美沙酮维持治疗的结果

摘要 目的：阿片类药物成瘾者的抑郁症合并症非常普遍，但他们在美沙酮维持治疗 (MMT) 中的结果尚未确定。方法：研究了新入院和已入院（5.5±4 年）的 MMT 患者的特征和结果（保留至 2017 年 12 月），在入院时可获得可用的汉密尔顿抑郁量表（HAM-D）评分。结果：入院时精神科治疗期间，330 名患者中有 70 名 (21.2%) 被诊断出超过临界值（HAM-D 评分 ≥ 18）的高度抑郁症状。抑郁组和非抑郁组的女性比例相似（20% 和 23.8%）和入院时年龄（43.0 ± 10.5 和 43.7 ± 10.4 岁），但抑郁组的简要精神病学评定量表 (BPRS) 得分较高 (21.4 ± 8.6)分别与 7.0 ± 7.3 相比；p < .0005)，少数族裔（非犹太信仰；28.6% 对 15.4%；p = .02）的比例更高，可卡因尿液筛查结果呈阳性的比例更高（55.7% 对 34.4%；p = .001）和入院时使用苯二氮卓类药物（74.3% 对 57.5%；p = .01）。1 年后的保留率相似（79% 和 80.7%），但抑郁患者的可卡因发生率更高（40.8% 对 25.5%；p = .05）和苯二氮卓使用率（59.2% 对 41.8%；p = .04 ) 和比非抑郁患者（6.8 年，95% CI [6.1, 7.5]；p = .05）更短的累积保留时间（5.6 年，95% 置信区间 [CI; 4.3, 7.0]）。在接受 MMT 评估的 263 人中，23.5% 的人患有抑郁症，其特征是女性较多（43.5% 对 23.4%）和有强奸史（34.5% 对 7.6%）。结论：新入院的抑郁症和非抑郁症患者在第一年的治疗保留中取得了相似的成功，尽管他们同时滥用了可卡因和苯二氮卓类药物。抑郁症的特点是女性和已经在 MMT 中的人有强奸史。建议对两个抑郁组进行充分干预，以改善长期保留和结果。