Drug abuse and psychiatric comorbidity

Psychiatric morbidity was studied in a sample of 176 opioid-dependent men recruited from prison and treatment services. The Diagnostic Interview Schedule (DIS) was used for psychiatric assessment. Lifetime and current prevalence of any mental disorder, excluding substance use disorders, reached 90.3% and 66.1%, respectively. The most prominent lifetime DSM-III axis I disorders were anxiety (31.8% lifetime and 16.5% last month) and affective (25% lifetime and 19.9% last month) disorders. Antisocial personality disorder (ASP) had a lifetime prevalence of 69.3%. Higher rates of affective and anxiety disorders were diagnosed in the treatment sample than in the imprisoned sample, whereas the inverse was observed for ASP. Results from the psychiatric interview showing a strong association between drug--opiate--dependence and DSM-III mental disorders are further supported by findings of high levels of depressive symptoms on the Center for Epidemiological Studies-Depression (CES-D) scale (71.5%) and increased rates of self-reported suicide attempts (27.4%) and psychiatric hospitalizations (26.8%). Psychiatric disorders seem to precede drug dependence in the majority of cases. Results from this study are compared and discussed with those from similar North American Studies.