Mood disorders in opioid-dependent patients

Aims: To assess the rate of current mood disorders in opioid-dependent outpatients. Design: Prevalence study of DSM-IV mood disorders. Settings: Private and government clinics. Participants: Five hundred unpaid opioid-dependent patients who had voluntarily sought treatment. Measurements: The Research version of structured clinical interview for DSM-IV Axis I Disorders (SCID-I). Results: The mean age of the subjects (487 men and 13 women) was 33.4 years, ranging from 16 to 67. The majority (68.2%) had private sector job and 13.4% were unemployed. The majority (59.8%) had education at the level of primary, guidance or high school and only 3.8% were illiterate. Three hundred and thirty six (67.2%) subjects were diagnosed as having mood disorders. Of the subjects 274 (54.8%) had substance induced depression, 37 (7.4%) major depression, 14 (2.8%) dysthymia, five (1%) depression due to general medical condition, three (0.6%) cylothymia, three (0.6%) bipolar mood disorder type I. None was diagnosed as having bipolar mood disorder type II. Of the participants 319 (63.8%) reported more than 5 years use of opioid. Of the subjects only 16 (3.2%) reported no episode of abstinence and the majority 484 (96.8%) reported one or more episodes of abstinences. About 4.2% (21) reported less than 1 g/day and the majority 86.4% (432) reported between 1 and 5 g/day current use of opioid. Conclusion: Due to high rates of mood disorders in opioid-dependent subjects, psychiatric services should be open and accessible to the patients, especially those who voluntarily seek help and treatment.