Western Sydney University, Sydney, NSW, Australia.
The Buttery, Binna Burra, QLD, Australia.
Addict Sci Clin Pract. 2019 Feb 4;14(1):4. doi: 10.1186/s13722-019-0132-x.
Residential opioid rehabilitation aims to improve the mental health and quality of life of opioid users through abstinence and residential program participation. This study aimed to determine the depression, anxiety, stress and quality of life amongst maintenance to abstinence (MTA) program residents. Secondary study aims were to assess the personal characteristics of MTA clients, addiction and risk taking behaviours, factors associated with program completion, as well as to assess the reliable change in participants' mental health and quality of life on exit.
Retrospective analysis of routinely collected data (2013-2017) from surveys completed by 100 clients. Outcome measures were: Depression, Anxiety, Stress Score (DASS-42), World Health Organisation Quality of Life 8 questions (WHOQOL-8) and Kessler Psychological Distress Scale (K10). Other variables included demographics, drug use, other addictions, aggression, self-harm, suicidal ideation/attempts, and risk taking behaviours. Statistical methods included Chi-square, Fisher's exact, t-tests, repeated measures analysis of variance and the Reliable Change Index.
All mean DASS-42, WHOQOL-8 and K10 scores improved significantly in all participants from entry to exit (p < 0.001). The majority of participants demonstrated reliable improvement across all psychometric measures. Completion rates for the MTA program were 51%. Depression (p = 0.023), anxiety (p = 0.010) and stress (p = 0.015) DASS-42 scores decreased significantly more in completers compared to non-completers. The rate of improvement in mean WHOQOL-8 scores and psychological distress scores (K10) was not statistically significantly different between completers and non-completers over time. There was no significant difference between completers and non-completers on socio-demographics, self-reported drug addiction or risk taking behaviour on program entry, except for suicidal thoughts while intoxicated (p = 0.033). Completers were more satisfied with their relationships (p = 0.044) and living place (p = 0.040) on program entry.
Overall, completers and non-completers demonstrated improved mental health and quality of life from entry to exit, regardless of program completion. Depression, anxiety and stress reduced more markedly in program completers. Policy makers and programmers could use these findings to further validate their own programs to improve mental health and quality of life of opioid users.
住宅阿片类药物康复旨在通过戒除和住院计划参与来改善阿片类药物使用者的心理健康和生活质量。本研究旨在确定维持到戒除（MTA）计划居民的抑郁、焦虑、压力和生活质量。次要研究目的是评估 MTA 客户的个人特征、成瘾和冒险行为、与计划完成相关的因素，以及评估参与者在退出时心理健康和生活质量的可靠变化。
对 2013 年至 2017 年期间完成的 100 名客户调查的常规收集数据进行回顾性分析。结果测量：抑郁、焦虑、压力量表（DASS-42）、世界卫生组织 8 个问题生活质量量表（WHOQOL-8）和凯斯勒心理困扰量表（K10）。其他变量包括人口统计学、药物使用、其他成瘾、攻击性、自残、自杀意念/尝试和冒险行为。统计方法包括卡方检验、Fisher 精确检验、t 检验、重复测量方差分析和可靠变化指数。
所有参与者的 DASS-42、WHOQOL-8 和 K10 评分均从进入到退出时显著改善（p<0.001）。大多数参与者在所有心理测量指标上均表现出可靠的改善。MTA 计划的完成率为 51%。与非完成者相比，完成者的抑郁（p=0.023）、焦虑（p=0.010）和压力（p=0.015）DASS-42 评分下降更为显著。完成者与非完成者在时间上的 WHOQOL-8 评分和心理困扰评分（K10）的改善率无统计学差异。除醉酒时自杀念头（p=0.033）外，完成者与非完成者在计划开始时的社会人口统计学、自我报告的药物成瘾或冒险行为上无显著差异。与非完成者相比，完成者在计划开始时对人际关系（p=0.044）和居住地点（p=0.040）更满意。
总体而言，无论是否完成计划，完成者和非完成者的心理健康和生活质量都从进入到退出时有所改善。在计划完成者中，抑郁、焦虑和压力的减轻更为明显。政策制定者和程序员可以利用这些发现来进一步验证他们自己的项目，以改善阿片类药物使用者的心理健康和生活质量。
