Frequency and correlates of co-morbid psychiatric illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit, South Africa

Dannatt, Lisa Gwen ; Weich, Lize (2014-08)

CITATION: Dannatt, L., Cloete, K.J., Kidd, M. & Weich, L. 2014. Frequency and correlates of comorbid psychiatric illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit, South Africa. South African Journal of Psychiatry , 20(3):77-82, doi:10.7196/SAJP.540.

The original publication is available at http://www.sajp.org.za/index.php/sajp

Article

Background. There is a lack of studies addressing the frequency and correlates of co-morbidities among heroin users admitted for treatment in South Africa. Objective. To assess the frequency and correlates of psychiatric co-morbidity among patients with heroin use disorder admitted to the Opioid Detoxification Unit at Stikland Hospital, Western Cape, South Africa. Method. Participants (N = 141) were assessed for psychiatric illness (Mini International Neuropsychiatric Interview), co-morbid substance use disorders (World Health Organization’s Alcohol Smoking Substance Involvement Screening Tool), legal and social problems (Maudsley Addiction Profile). Demographic, personal, psychiatric and substance use history, in addition to mental state examination on admission, were collected from the case notes. Results. Most participants had never been abstinent from heroin (56; 40%), had been arrested for drug related activities (117; 83%), and had family conflicts related to use (135; 96%). Nicotine was the most common co-morbid substance of dependence (137; 97%) and methamphetamine was the most common co-morbid substance abused (73; 52%). The most common co-morbid psychiatric illness was previous substance induced psychosis (42; 30%) and current major depressive disorder (37; 26%). Current major depressive disorder was significantly associated with female gender (p = 0.03), intravenous drug use (p = 0.03), alcohol use (p = 0.02), and a higher number of previous rehabilitation attempts (p = 0.008). Conclusion. Patients with heroin use disorders present with high rates of psychiatric co-morbidities that underscore the need for substance treatment services with the capacity to diagnose and manage these co-morbidities.

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