Psychiatric comorbidities among Iranian elderly patients on methadone maintenance treatment

Comorbidity of psychiatric disorders and substance abuse can intensify both conditions, and when advanced age is added to the combination, the patient will face a distinctive array of issues. This study evaluated the prevalence of psychiatric disorders in elderly substance users as well as certain related factors.

This cross-sectional study was performed on 160 consenting elderly substance users 60 years and over who had been on methadone maintenance. The subjects were selected from rehabilitation centers affiliated with the Welfare Organization in Tehran through convenience sampling, and were assessed for current or lifetime axis-I psychiatric disorders using the SCID questionnaire.

In this study, 28.1% of substance abusers were diagnosed with at least one current psychiatric disorder. Psychiatric disorders were more common in subjects whose dependence had started prior to the age of 35, or those who had a family history of substance use. Also, 34.4% had a lifetime history of at least one psychiatric disorder, with a higher incidence among those simultaneously dependent on other substances in addition to opioids. Major depression was the most prevalent disorder among the study subjects.

Based on the findings of the present study, axis-I psychiatric disorders are rather common among elderly substance users, and approximately a third of this population have a lifetime history of at least one such disorder. The type of abused substance can affect the incidence of psychiatric disorders, and simultaneous use of non-opioids and other substances can increase their prevalence.