Psychiatric comorbidity and severity of dependence on substance users: how it impacts on their health-related quality of life?

Abstract

Objective: The aim of this study was to analyze the impact of psychiatric comorbidity and severity of dependence on health-related quality of life (HRQoL).

Methods: One hundred and ninety-eight substance use disorder (SUD) patients were recruited from an outpatient center that provides treatment for SUD. The International Personality Disorder Examination Screening Questionnaire (IPDE-SQ), Mini International Neuropsychiatric Interview (MINI), Substance Dependence Severity Scale (SDSS) and Health-Related Quality of Life for Drug Abusers test (HRQoLDA test) were administered.

Results: Patients with psychiatric comorbidity evaluated their HRQoL more negatively than patients without psychiatric comorbidity. An analysis of the relationship between severity of dependence and HRQoL scores indicated significant correlations among alcohol-, cocaine-, heroin- and cannabis-dependent patients. According to multivariate analyses, anxiety disorders, mood disorders, severity of dependence on alcohol, cannabis, cocaine, paranoid, borderline and avoidant personality disorders (PDs) were observed to have a major impact on HRQoL.

Conclusions: SUD (severity of dependence on alcohol, cannabis and cocaine) and other mental disorders (anxiety disorders; mood disorders; paranoid, borderline and avoidant PDs) are involved in the deterioration of the SUD patients’ HRQoL. This study demonstrates the need for integrated treatment for SUD patients. Treating only a part of the problem (whether SUD or other mental disorders are present) is insufficient for improving quality of life.

• Comorbidity
• health-related quality of life
• severity of dependence
• dual diagnosis
• substance abuse

Acknowledgements

The authors wish to thank the staff and patients of Huelva Provincial Drug Dependence Service.

Declaration of interest

This study was funded by a grant under the “Diagnosis of the Severity of Dependence to Psychoactive Substances according to DSM-IV Criteria: Adaptation to Spanish of the Substance Dependence Severity Scale clinical interview (PI10/01155)” Project from the Carlos III Institute of Health and the European Regional Development Fund (EDRF). Carlos III Institute of Health and EDRF had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

The authors declare that they have no conflicts of interest.