National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China.
Addiction. 2015 Jan;110 Suppl 1:51-60. doi: 10.1111/add.12780.
To estimate the prevalence of, and identify factors associated with, depression and anxiety among community-based methadone maintenance treatment (MMT) clients in China.
A cross-sectional survey.
Nine MMT clinics, three each from three Chinese provinces (Yunnan, Anhui and Jiangsu) between October 2008 and February 2009.
A total of 1301 MMT clients.
A questionnaire, including the Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS), and on-site urine drug testing.
The prevalence of depression (SDS score≥53) and anxiety (SAS score≥50) in our sample was 38.3% [95% confidence interval (CI)=35.7, 40.9] and 18.4% (95% CI=16.3, 20.5), respectively, with 14.2% (95% CI=12.3, 16.1) displaying symptoms of both. Sample prevalence rates for depression [mean=49.69, standard deviation (SD)=10.34] and anxiety (mean=40.98, SD=10.66) were higher than the national average for each (t(0.05/2, 1300)=19.2, P<0.001 and t(0.05/2, 1300)=8.0, P<0.001, respectively). Employing multi-level modelling techniques, gender (P=0.03) and employment status (P<0.001) were found to be associated significantly with depression in a single-level model; however, in a multi-level mixed model, only employment status (P<0.001) was associated with depression. Gender (P=0.03), education level (P=0.02), marital status (P=0.04), employment status (P<0.001), positive urine drug test results (P=0.02) and daily methadone dose (P<0.001) were found to be associated significantly with anxiety in a single-level model, while only employment status (P<0.01) and positive results for the urine drug test (P=0.04) were associated with anxiety in a multi-level mixed model.
A considerable proportion of methadone maintenance treatment clients in China have experienced depression and anxiety during treatment. There is a need to provide tailored mental health interventions for this high-risk population.
评估中国社区美沙酮维持治疗（MMT）患者中抑郁和焦虑的流行情况，并确定其相关因素。
横断面调查。
2008 年 10 月至 2009 年 2 月期间，中国三个省份（云南、安徽和江苏）的九个 MMT 诊所，每个省份各三个。
共 1301 名 MMT 患者。
问卷调查，包括 Zung 自评抑郁量表（SDS）和 Zung 自评焦虑量表（SAS）以及现场尿液药物检测。
在我们的样本中，抑郁（SDS 得分≥53）和焦虑（SAS 得分≥50）的患病率分别为 38.3%（95%置信区间[CI]=35.7, 40.9）和 18.4%（95% CI=16.3, 20.5），其中 14.2%（95% CI=12.3, 16.1）同时存在两种症状。样本中抑郁的发生率[均值=49.69，标准差（SD）=10.34]和焦虑的发生率[均值=40.98，SD=10.66]均高于各自的全国平均水平（t（0.05/2, 1300）=19.2，P<0.001 和 t（0.05/2, 1300）=8.0，P<0.001）。采用多水平模型技术，在单水平模型中发现性别（P=0.03）和就业状况（P<0.001）与抑郁显著相关；然而，在多水平混合模型中，只有就业状况（P<0.001）与抑郁相关。在单水平模型中，性别（P=0.03）、教育程度（P=0.02）、婚姻状况（P=0.04）、就业状况（P<0.001）、尿液药物检测阳性结果（P=0.02）和日美沙酮剂量（P<0.001）与焦虑显著相关，而在多水平混合模型中，只有就业状况（P<0.01）和尿液药物检测阳性结果（P=0.04）与焦虑相关。
中国相当一部分美沙酮维持治疗患者在治疗期间经历了抑郁和焦虑。需要为这一高危人群提供针对性的心理健康干预措施。
