Skip to main content Accessibility help
×
Home

Psychiatric symptoms among clients seeking treatment for drug dependence: Intake data from the National Treatment Outcome Research Study

  • John Marsden (a1), Michael Gossop (a1), Duncan Stewart (a1), Alexandra Rolfe (a1) and Michael Farrell (a1)...

Abstract

Background

Many people with substance use disorders are vulnerable to other psychiatric disorders and present to addiction treatment services with comorbid psychiatric symptoms.

Aims

To describe the prevalence of recent psychiatric treatment and current psychiatric symptoms and explore links between substance misuse, personal/social functioning and symptom severity.

Method

Subjects were 1075 adults recruited to the National Treatment Outcome Research Study (NTORS), of whom 90% were opiate-dependent. Psychiatric symptoms at intake were recorded using sub-scales from the Brief Symptom Inventory.

Results

Recent psychiatric treatment was reported by one in five subjects. Psychiatric symptom levels were high and females had elevated scores on all scales. Symptoms were elevated among opiate users who were also frequent users of benzodiazepines, alcohol and, in particular, stimulants. Gender, physical health, drug dependence and personal relationship problems were more powerful predictors of psychiatric symptoms than substance use.

Conclusions

Addictions service providers should be vigilant to psychiatric problems among their clients at intake to treatment. Psychiatric symptoms are more closely linked to polydrug use than to opiate use in this population.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Psychiatric symptoms among clients seeking treatment for drug dependence
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Psychiatric symptoms among clients seeking treatment for drug dependence
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Psychiatric symptoms among clients seeking treatment for drug dependence
      Available formats
      ×

Copyright

Corresponding author

Dr John Marsden, National Addiction Centre, Institute of Psychiatry/Maudsley Hospital, 4 Windsor Walk, London SE5 8AF. Tel: 020 7919 3830; e-mail: J.Marsden@iop.kcl.ac.uk

Footnotes

Hide All

Declaration of interest

NTORS is funded by the Department of Health.

Footnotes

References

Hide All
Alterman, A. I., McLellan, T. & Shifman, R. B. (1993) Do substance patients with more psychopathology receive more treatment? Journal of Nervous and Mental Disease, 181, 576582.
Darke, S., Ward, J., Zadar, D., et al (1991) A scale for estimating the health status of opioid users. British Journal of Addiction, 86, 13171322.
Darke, S., Swift, W. & Hall, W. (1994) Prevalence, severity and correlates of psychological morbidity among methadone maintenance clients. Addiction, 89, 211217.
Derogatis, L. R. (1993) The Brief Symptom Inventory: Administration, Scoring and Procedures. Minneapolis, MN: National Computer Systems.
Farrell, M., Howes, S., Taylor, C., et al (1998) Substance misuse and psychiatric comorbidity: an overview of the OPCS national psychiatric morbidity survey. Addictive Behaviors, 23, 909918.
Gossop, M., Darke, S., Griffiths, P., et al (1995) The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90, 607614.
Gossop, M., Marsden, J. & Stewart, D. (1998a) NTORS at One Year. Results from the National Treatment Outcome Research Study. London: Department of Health.
Gossop, M., Marsden, J. & Stewart, D. et al (1998b) Substance use, health and social problems of service users at 54 drug treatment agencies. Intake data from the National Treatment Outcome Research Study. British Journal of Psychiatry, 173, 166171.
Hall, W. & Farrell, M. (1997) Comorbidity of mental disorders with substance misuse. British Journal of Psychiatry, 171, 45.
Harris, E. C. & Barraclough, B. (1997) Suicide as an outcome for mental disorders. A meta-analysis. British Journal of Psychiatry, 170, 205228.
Johnson, S. (1997) Dual diagnosis of severe mental illness and substance misuse: a case for specialist services? British Journal of Psychiatry, 171, 205208.
Kessler, R. C., McGonagle, K. A., Zhao, S., et al (1994) Lifetime and 12 month prevalence of DSM–III–R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 819.
Kleinman, P. H., Miller, A. B., Millman, R. B., et al (1990) Psychopathology among cocaine abusers entering treatment. Journal of Nervous and Mental Disease, 178, 442447.
Marsden, J., Gossop, M., Stewart, D., et al (1998) The Maudsley Addiction Profile: a brief instrument for assessing treatment outcome. Addiction, 93, 18571867.
McLellan, A. T., Kushner, H., Metzger, D., et al (1992) The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9, 199213.
Regier, D. A., Farmer, M. E., Rae, D. S., et al (1990) Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) study. Journal of the American Medical Association, 264, 25112518.
Rounsaville, B. J., Weissman, M. M., Kleber, H. K., et al (1982) Heterogeneity of psychiatric diagnosis in treated opiate addicts. Archives of General Psychiatry, 39, 161166.
Scott, J., Gilvarry, E. & Farrell, M. (1998) Managing anxiety and depression in alcohol and drug dependence. Addictive Behaviors, 23, 919931.
Strain, E. C., Booner, R. K. & Bigelow, G. E. (1991) Clustering of multiple substance use and psychiatric diagnosis in opiate addicts. Drug and Alcohol Dependence, 27, 127134.
Swift, W., Williams, G., Neill, O., et al (1990) The prevalence of minor psychopathology in opioid users seeking treatment. British Journal of Addiction, 85, 629634.
Task Force to Review Services for Drug Misusers (1996) Report of an Independent Review of Drug Treatment Services in England. London: Department of Health.
Ward, J., Mattick, R. P. & Hall, W. (1998) Psychiatric comorbidity among the opioid dependent. In Methadone Maintenance Treatment and Other Opioid Replacement Therapies (eds Ward, J., Mattick, R. P. & Hall, W.), pp. 419440. Amsterdam: Harwood Academic.
World Health Organization (1992) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Psychiatric symptoms among clients seeking treatment for drug dependence: Intake data from the National Treatment Outcome Research Study

  • John Marsden (a1), Michael Gossop (a1), Duncan Stewart (a1), Alexandra Rolfe (a1) and Michael Farrell (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *