TY - JOUR
KW - mental disorder
KW - mental health problems
KW - opioid dependence
KW - opioid substitution treatment
KW - Psychological Distress
KW - Substance Abuse
KW - Substance use disorder
AU - C. F. Aas
AU - J. H. Vold
AU - R. Gjestad
AU - S. Skurtveit
AU - A. G. Lim
AU - K. V. Gjerde
AU - E. M. Løberg
AU - K. A. Johansson
AU - L. T. Fadnes
AU - INTRO-HCV Study Group
A1 - 
AB - BACKGROUND: There is high co-occurrence of substance use disorders (SUD) and mental health disorders. We aimed to assess impact of substance use patterns and sociodemographic factors on mental health distress using the ten-item Hopkins Symptom Checklist (SCL-10) over time. METHODS: Nested prospective cohort study of 707 participants with severe SUD across nine opioid-agonist-therapy outpatient clinics and low-threshold municipality clinics in Norway, during 2017-2020. Descriptive statistics were derived at baseline and reported by means and standard deviation (SD). A linear mixed model analysis was used to assess the impact of substance use patterns and sociodemographic factors on SCL-10 sum score with beta coefficients with 95% confidence intervals (CI). RESULTS: Mean (SD) SCL-10 score was 2.2 (0.8) at baseline with large variations across patients. We observed more symptoms of mental health disorders among people with frequent use of benzodiazepines (beta 3.6, CI:2.4;4.8), cannabis (1.3, CI:0.2;2.5), opioids (2.7, CI:1.1;4.2), and less symptoms among people using frequent stimulant use (- 2.7, CI:-4.1;-1.4) compared to no or less frequent use. Females (1.8, CI:0.7;3.0) and participants with debt worries (2.2, CI:1.1;3.3) and unstable living conditions (1.7, CI:0.0;3.3) had also higher burden of mental health symptoms. There were large individual variations in SCL-10 score from baseline to follow-up, but no consistent time trends indicating change over time for the whole group. 65% of the cohort had a mean score > 1.85, the standard reference score. CONCLUSIONS: People with SUD have a considerable burden of mental health symptoms. We found no association between substance use patterns and change in mental health symptoms over time. This could suggest that the differences observed were indicating flattening of effects or self-medication to a larger degree than medication-related decline in mental health. This call for better individualized mental health assessment and patient care.
AD - Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway. christer.frode.aas@helse-bergen.no.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. christer.frode.aas@helse-bergen.no.; Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.; Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.; Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Psychology, University of Bergen, Bergen, Norway.; Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.; Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BT - Substance abuse treatment, prevention, and policy
C5 - Healthcare Disparities; Measures; Opioids & Substance Use
CP - 1
DO - 10.1186/s13011-021-00354-1
IS - 1
JF - Substance abuse treatment, prevention, and policy
LA - eng
M1 - Journal Article
N2 - BACKGROUND: There is high co-occurrence of substance use disorders (SUD) and mental health disorders. We aimed to assess impact of substance use patterns and sociodemographic factors on mental health distress using the ten-item Hopkins Symptom Checklist (SCL-10) over time. METHODS: Nested prospective cohort study of 707 participants with severe SUD across nine opioid-agonist-therapy outpatient clinics and low-threshold municipality clinics in Norway, during 2017-2020. Descriptive statistics were derived at baseline and reported by means and standard deviation (SD). A linear mixed model analysis was used to assess the impact of substance use patterns and sociodemographic factors on SCL-10 sum score with beta coefficients with 95% confidence intervals (CI). RESULTS: Mean (SD) SCL-10 score was 2.2 (0.8) at baseline with large variations across patients. We observed more symptoms of mental health disorders among people with frequent use of benzodiazepines (beta 3.6, CI:2.4;4.8), cannabis (1.3, CI:0.2;2.5), opioids (2.7, CI:1.1;4.2), and less symptoms among people using frequent stimulant use (- 2.7, CI:-4.1;-1.4) compared to no or less frequent use. Females (1.8, CI:0.7;3.0) and participants with debt worries (2.2, CI:1.1;3.3) and unstable living conditions (1.7, CI:0.0;3.3) had also higher burden of mental health symptoms. There were large individual variations in SCL-10 score from baseline to follow-up, but no consistent time trends indicating change over time for the whole group. 65% of the cohort had a mean score > 1.85, the standard reference score. CONCLUSIONS: People with SUD have a considerable burden of mental health symptoms. We found no association between substance use patterns and change in mental health symptoms over time. This could suggest that the differences observed were indicating flattening of effects or self-medication to a larger degree than medication-related decline in mental health. This call for better individualized mental health assessment and patient care.
PY - 2021
SN - 1747-597X; 1747-597X
SP - 20
T1 - Substance use and symptoms of mental health disorders: a prospective cohort of patients with severe substance use disorders in Norway
T2 - Substance abuse treatment, prevention, and policy
TI - Substance use and symptoms of mental health disorders: a prospective cohort of patients with severe substance use disorders in Norway
U1 - Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 33639969
U3 - 10.1186/s13011-021-00354-1
VL - 16
VO - 1747-597X; 1747-597X
Y1 - 2021
Y2 - Feb 27
ER -