BACKGROUND AND OBJECTIVES Substance use disorders are highly prevalent among individuals with psychotic disorders and are associated with negative outcomes. This study aims to explore differences in characteristics and treatment outcomes for individuals with psychotic disorders as compared to individuals with other non-psychotic psychiatric disorders enrolled in treatment for opioid use disorder (OUD). METHODS Data were collected from a prospective cohort study of 415 individuals enrolled in outpatient methadone maintenance treatment (MMT). Psychiatric comorbidity was assessed using the Mini-International Neuropsychiatric Interview. Participants were followed for 12 months. Participant characteristics associated with having a psychotic disorder versus another non-psychotic psychiatric disorder were explored by logistic regression analysis. RESULTS Altogether, 37 individuals (9%) with a psychotic disorder were identified. Having a psychotic disorder was associated with less opioid-positive urine drug screens (OR=0.97, 95% CI 0.95,0.99, p=0.046). Twelve-month retention in treatment was not associated with psychotic disorder group status (OR=0.73, 95% CI 0.3,1.77, p=0.485). Participants with psychotic disorders were more likely to be prescribed antidepressants (OR=2.12, 95% CI 1.06,4.22, p=0.033), antipsychotics (OR=3.57, 95% CI 1.74,7.32, p=0.001), mood-stabilizers (OR=6.61, 95% CI 1.51,28.97, p=0.012), and benzodiazepines (OR=2.22, 95% CI 1.11,4.43, p=0.024). DISCUSSION AND CONCLUSIONS This study contributes to the sparse literature on outcomes of individuals with psychotic disorders and OUD receiving MMT. Rates of retention in treatment and opioid use are encouraging and contrast to the widely held belief that these individuals do more poorly in treatment. Higher rates of co-prescription of sedating and QTc prolonging medications in this group may pose unique safety concerns.

中文翻译：

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精神病和共病阿片类药物使用障碍：阿片类药物替代疗法的特征和结果。

背景和目标 物质使用障碍在精神病患者中非常普遍，并与负面结果相关。本研究旨在探讨精神障碍患者与其他非精神病性精神障碍患者在阿片类药物使用障碍 (OUD) 治疗中的特征和治疗结果的差异。方法 数据来自一项前瞻性队列研究，该研究纳入了 415 名参加门诊美沙酮维持治疗 (MMT) 的个体。使用迷你国际神经精神病学访谈评估精神病合并症。参与者被跟踪了 12 个月。通过逻辑回归分析探讨了与患有精神病性障碍与另一种非精神病性精神障碍相关的参与者特征。结果 总共确定了 37 名精神病患者（9%）。患有精神病与较少的阿片类药物阳性尿液药物筛查相关（OR=0.97, 95% CI 0.95,0.99, p=0.046）。12 个月的治疗保留与精神病组状态无关（OR=0.73, 95% CI 0.3,1.77, p=0.485）。患有精神疾病的参与者更有可能服用抗抑郁药（OR=2.12, 95% CI 1.06,4.22, p=0.033），抗精神病药（OR=3.57, 95% CI 1.74,7.32, p=0.001），情绪稳定剂（ OR=6.61, 95% CI 1.51,28.97, p=0.012) 和苯二氮卓类药物 (OR=2.22, 95% CI 1.11,4.43, p=0.024)。讨论和结论 本研究有助于关于精神病患者和 OUD 接受 MMT 治疗结果的文献稀少。治疗的保留率和阿片类药物的使用令人鼓舞，这与人们普遍认为这些人在治疗中做得更差的观点形成鲜明对比。在该组中较高的镇静剂和 QTc 延长药物的共同处方率可能会带来独特的安全问题。