Dual Diagnosis and Quality of Life in Patients in Treatment for Opioid Dependence

Abstract

This study examined the relationship between quality of life (QOL) and dual diagnosis among patients in treatment for opioid dependence. The study sample includes 57 patients with opioid dependence alone (OD) and 41 with opioid dependence and a psychiatric axis-I disorder (DD), recruited in 2001 and 2004 at the Drug Addiction Services (SerT) of Bolzano and Pontedera (Italy). Participants were 73.5% males, with a mean age of 35.1 years (SD = 8.0). A comparison group of 45 healthy controls was also included. Assessments included a structured psychiatric interview (SCID) and a self-report quality of life assessment (WHOQOL-BREF). Patients with DD reported significantly (p < 0.05) poorer QOL in the physical and psychological domains as compared with patients with OD. Both groups of patients with and without DD showed significantly (p < 0.001) poorer QOL in the physical, psychological, and social domains with respect to healthy participants. The scores on the “relationship with environment” domain did not differ among OD, DD, and controls. The present study provides preliminary evidence that dual diagnosis is associated with poorer QOL and emphasizes the need to target treatment for the mental disorder concomitantly with the dependence problem in patients in treatment for opioid dependence.

Keywords:

• dual diagnosis
• quality of life
• opioid dependence

Additional information

Notes on contributors

Jacopo Bizzarri

Jacopo Bizzarri, M.D., psychiatrist. He has been working since 2000 at the Drug Addiction Service of Bolzano. His main research interests are in psychiatric comorbidity in drug users.

Paola Rucci

Paola Rucci, statistician and research assistant professor of psychiatry at the University of Pittsburgh. She is currently working at Department of Psychiatry, University of Pisa as coordinator of a NIMH study on phenotypes of depression. Her main research interests are related to instrument development, validation and testing in clinical practice.

Alessia Vallotta

Alessia Vallotta, psychologist. She has worked from 1997 to 1999 in a therapeutic community for patients with psychiatric disorders. She has been working at the Drug Addiction Service of Bolzano since 2000. Her main research interests are related to dual diagnosis, eating disorders and bioenergetic analysis.

Massimo Girelli

Massimo Girelli, psychologist, PhD. in Experimental Psychology. He has been working at the Drug Addiction Service of Bolzano since 1998 as researcher on epidemiology of substance use (funded by the Italian ‘Fondo Nazionale Lotta alla Droga’), and as clinical psychologist from 2002. His interests in this research field include neuropsychology of addiction and related mental diseases.

Anna Scandolari

Anna Scandolari, MD. She has been working since 1990 at the Drug Addiction Services of Bolzano and currently is Assistant Chief and Medical Coordinator. She is interested in the field of research on designer drugs and group-analytical therapy and collaborates with a Health and Social Network for treatment of parents with opioid dependence and their children.

Elisabetta Zerbetto

Elisabetta Zerbetto, M.D., toxicologist. She has been working at the Drug Addiction Service of Bolzano since 1998.

Alfredo Sbrana

Alfredo Sbrana, M.D., psychiatrist. He has been working since 1987 in the field of drug use and has been the Head of the Drug Addiction Service of Pisa for five years. He is currently working at the male inpatient unit of the Department of Psychiatry of the University of Pisa. His main research interests are the spectrum of substance use and its relationship with mental disorders.

Claudia Iagher

Claudia Iagher, specialist in rehabilitation in psychiatry at the Department of Psychiatry, University of Pisa. Her main research interests are in quality of life of drug users.

Elio Dellantonio

Elio Dellantonio, M.D., psychiatrist. He has worked at the psychiatric Hospital and at the psychiatric outpatients and rehabilitation services in Bolzano from 1979 to 1989. Since 1989 is Head of the Drug Addiction Service of Bolzano.