Retention in a methadone program me: The importance of psychopathology. A prospective study

Abstract

The first 50 clients in the national methadone programme in Norway were followed prospectively for an average of 2 years. We investigated the type and degree of psychopathology, and to what extent differences in psychopathology were related to retention. The clients were interviewed at intake by using a structured diagnostic interview (SCID-II), and completed three self-report questionnaires (MCMI, SCL-25, BDI), both at intake and after 4 months treatment. Half of the clients had an antisocial personality disorder, and almost half were suffering from depression and anxiety. After 4 months of treatment, the MCMI scores on passive-aggressive, borderline, compulsive arid psychotic depression differentiated significantly between clients who were or were not in the programme at the end of the observation period. At this time 67% were still in the programme and doing well. Antisocial clients stayed on in treatment to the same extent as clients without a personality disorder. Additional treatment such as counselling, specific psychotherapy and/or antidepressant drugs might help those clients at most risk of dropping out early from treatment.