Psychiatric and behavioral disorders in patients undergoing opioid agonist maintenance therapy
DOI:
https://doi.org/10.26641/2307-0404.2025.3.340755Ключові слова:
methadone, substitution maintenance therapy, opioid agonists, mental and behavioral disorders in addicts, comorbidity of disorders in addicts, anxiety, depression, quality of lifeАнотація
The aim of this study was to analyze anxiety, depression, aggression, cognitive impairments, and quality of life in patients receiving methadone maintenance therapy. The study was conducted in 2024 at one of the methadone maintenance therapy sites of the Municipal Enterprise «Dnipropetrovsk multidisciplinary clinical hospital for the provision of psychiatric care» Dnipropetrovsk Regional Council». A total of 150 patients aged 26 to 64 years participated in the study, including 117 (78.0%) men and 33 (22.0%) women. The participants were divided into the main group (101 individuals) and the comparison group (49 individuals). The study employed clinical-anamnestic, clinical-psychopathological, and psychodiagnostic methods, including the Symptom Checklist-90-Revised (SCL-90-R), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Buss-Durkee Hostility Inventory, the Montreal Cognitive Assessment (MoCA), and the World Health Organization Quality of Life Brief Questionnaire (WHOQOL-BREF). The results indicated that the median levels of depression 13,0 [7,0; 19,0] and anxiety 15,0 [8,0; 22,0] in the total sample and both groups corresponded to a mild severity. Most patients exhibited mild anxiety (60,7%). Depression assessment revealed that the majority of patients either had no depression (28,7%) or presented with mild symptoms (24,0%). The majority of participants had no cognitive impairment (45,3%) or only mild deficits (54,7%). Patients demonstrated normal levels of aggression 19,0 [16,0; 24,0] but exhibited an increased level of hostility 10,0 [8,0; 12,0]. At baseline, mild anxiety and depressive symptoms predominated among patients receiving methadone therapy. Elevated hostility was observed, whereas overall aggression remained within the normative range. Cognitive impairment was absent or mild. These baseline findings may inform the development of differentiated treatment strategies for this cohort.
Посилання
Volkow ND, Blanco C. The Changing Opioid Crisis: development, challenges and opportunities. Mol Psychiatry. 2021;26:218-33. doi: https://doi.org/10.1038/s41380-020-0661-4
Hornberger J, Chhatwal J. Opioid Misuse: A Global Crisis. Value Health. 2021;24:145-6. doi: https://doi.org/10.1016/j.jval.2020.12.003
Humphreys K, Shover CL, Andrews CM, Bohnert ASB, Brandeau ML, Caulkins JP, et al. Responding to the Opioid Crisis in North America and Beyond: Recom¬mendations of the Stanford-Lancet Commission. Lancet Lond Engl. 2022;399:555-604. doi: https://doi.org/10.1016/S0140-6736(21)02252-2.
Fipps DC, Oesterle TS, Kolla BP. Opioid Maintenance Therapy: A Review of Methadone, Bupreno-rphine, and Naltrexone Treatments for Opioid Use Disorder. Semin Neurol. 2024 Aug;44(4):441-51. doi: https://doi.org/10.1055/s-0044-1787571
Pilarinos A, Kwa Y, Joe R, Dong H, Grant C, Fast D, et al. Methadone Maintenance Treatment Discon-tinuation Among Young People who use Opioids in Vancouver, Canada. Can J Psychiatry. 2023 Feb;68(2):89-100. doi: https://doi.org/10.1177/07067437221136468
Santo T, Clark B, Hickman M, Grebely J, Camp-bell G, Sordo L, et al. Association of Opioid Agonist Treatment With All-Cause Mortality and Specific Causes of Death Among People With Opioid Dependence: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2021;78:979-93. doi: https://doi.org/10.1001/jamapsychiatry.2021.0976
Pilarinos A, Kwa Y, Joe R, Thulien M, Buxton JA, DeBeck K, et al. Navigating Opioid Agonist Therapy among Young People who use Illicit Opioids in Vancouver, Canada. Int J Drug Policy. 2022;107:103773. doi: https://doi.org/10.1016/j.drugpo.2022.103773
Stuikyte R, Varentsov I, Cook C, Dvoriak S. Measuring sustainability of opioid agonist therapy programs in the context of transition from Global Fund support. Harm Reduct J. 2024;21:7. doi: https://doi.org/10.1186/s12954-024-00931-0
Cao P, Zhang Z, Zhong J, Xu S, Huang Q, Fan N. Effects of treatment status and life quality on anxiety in MMT patients. Subst Abuse Treat Prev Policy. 2021 Jan 13;16(1):9. doi: https://doi.org/10.1186/s13011-021-00343-4
Chang HM, Huang MC, Fang SC, Lin SK. Quality of life and associated factors of heroin-dependent patients receiving methadone and buprenorphine maintenance treatment. Neuropsychopharmacol Rep. 2023 Dec;43(4):607-15. doi: https://doi.org/10.1002/npr2.12402
Kelly LM, Alessi SM, Rash CJ, Zajac K. Predictors of Suicidal Ideation and Continued Substance Use Problems Among Patients Receiving Methadone Main-tenance Treatment Who Have Co-Occurring Cocaine Use Disorder. Subst Use Misuse. 2024;59(5):752-62. doi: https://doi.org/10.1080/10826084.2024.2302131
The Universal Declaration on Bioethics and Human Rights. Int Soc Sci J. 2005;57:745-53. doi: https://doi.org/10.1111/j.1468-2451.2005.00592.x
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191-4. doi: https://doi.org/10.1001/jama.2013.281053
Dembitskyi S, Sereda Yu. [Leonard Derogatis Symptom Questionnaire (SCL-90-R): validation in Ukraine]. Sotsiolohiia: teoriia, metody, marketynh. [Internet]. [cited 2025 Apr 29]. 2015;4:40-71. Ukrainian. Available from: http://jnas.nbuv.gov.ua/j-pdf/stmm_2015_4_5.pdf
Chaban OS, Khaustova OO. [Practical psychoso-matics: diagnostic scales]. 2025. p. 49-54, 76-78, 184-91. Ukrainian.
Stepaniuk O, Melnychenko O. [Methodological guide for professionals implementing a typical program for offenders: A collection of practical materials]. Kyiv; 2020. p. 14-20. Ukrainian.
Development of the World Health Organization WHOQOL-BREF quality of life assessment [Internet]. [cited 2025 Apr 29]. Available from: https://www.who.int/tools/whoqol/whoqol-bref/docs/default-source/publishing-policies/whoqol-bref/ukrainian-whoqol-bref
Torres D, Normando D. Biostatistics: essential concepts for the clinician. Dent Press J Orthod. 2021;26:e21spe1. doi: https://doi.org/10.1590/2177-6709.26.1.e21spe1
Chang TG, Yen TT, Hsu WY, Chang SM. Frontal Lobe Functions, Demoralization, Depression and Craving as Prognostic Factors and Positive Outcomes of Patients with Heroin Use Disorder Receiving 6 Months of Methadone Maintenance Treatment. Int J Environ Res Public Health. 2022 Mar 20;19(6):3703. doi: https://doi.org/10.3390/ijerph19063703
Bahji A, Bastien G, Bach P, Choi J, Le Foll B, Lim R, Jutras-Aswad D, Socias ME. The Association Between Self-Reported Anxiety and Retention in Opioid Agonist Therapy: Findings From a Canadian Pragmatic Trial. Can J Psychiatry. 2024 Mar;69(3):172-82. doi: https://doi.org/10.1177/07067437231194385
Zhao W, Duan F, Li X, Li J, Xia L, Ren Z, et al. Cognitive control in individuals with heroin use disorder after prolonged methadone maintenance treatment. BMC Psychiatry. 2025;25:78. doi: https://doi.org/10.1186/s12888-025-06523-x
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