Addiction (Abingdon, England) · 2012
Opioid dependence during pregnancy: relationships of anxiety and depression symptoms to treatment outcomes.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Benningfield Margaret M, Dietrich Mary S, Jones Hendrée E, Kaltenbach Karol, Heil Sarah H, Stine Susan M, Coyle Mara G, Arria Amelia M, O'Grady Kevin E, Fischer Gabriele, Martin Peter R
Аннотация
AIMS: To examine the relationship of anxiety and depression symptoms with treatment outcomes (treatment discontinuation, rates of ongoing use of illicit drugs and likelihood of preterm delivery) in opioid-dependent pregnant women and describe their use of psychotropic medications.
DESIGN AND SETTING: Secondary data analysis from a randomized clinical trial of treatment for opioid dependence during pregnancy.
PARTICIPANTS: A total of 175 opioid-dependent pregnant women, of whom 131 completed treatment.
MEASUREMENTS: Symptoms of anxiety and depression were captured with the 15-item Mini International Neuropsychiatric Interview (MINI) screen. Use of illicit drugs was measured by urine drug screening. Preterm delivery was defined as delivery prior to 37 weeks' gestation. Self-reported use of concomitant psychotropic medication at any point during the study was recorded.
FINDINGS: Women reporting only anxiety symptoms at study entry were more likely to discontinue treatment [adjusted odds ratio (OR) = 4.56, 95% confidence interval (CI) : 1.91-13.26, P = 0.012], while those reporting only depression symptoms were less likely to discontinue treatment (adjusted OR = 0.14, 95% CI : 0.20-0.88, P = 0.036) compared to women who reported neither depression nor anxiety symptoms. No statistically significant between-group differences were observed for ongoing illicit drug use or preterm delivery. A majority (61.4%) of women reported use of concomitant psychotropic medication at some point during study participation.
CONCLUSIONS: Opioid agonist-treated pregnant patients with co-occurring symptoms of anxiety require additional clinical resources to prevent premature discontinuation.
DESIGN AND SETTING: Secondary data analysis from a randomized clinical trial of treatment for opioid dependence during pregnancy.
PARTICIPANTS: A total of 175 opioid-dependent pregnant women, of whom 131 completed treatment.
MEASUREMENTS: Symptoms of anxiety and depression were captured with the 15-item Mini International Neuropsychiatric Interview (MINI) screen. Use of illicit drugs was measured by urine drug screening. Preterm delivery was defined as delivery prior to 37 weeks' gestation. Self-reported use of concomitant psychotropic medication at any point during the study was recorded.
FINDINGS: Women reporting only anxiety symptoms at study entry were more likely to discontinue treatment [adjusted odds ratio (OR) = 4.56, 95% confidence interval (CI) : 1.91-13.26, P = 0.012], while those reporting only depression symptoms were less likely to discontinue treatment (adjusted OR = 0.14, 95% CI : 0.20-0.88, P = 0.036) compared to women who reported neither depression nor anxiety symptoms. No statistically significant between-group differences were observed for ongoing illicit drug use or preterm delivery. A majority (61.4%) of women reported use of concomitant psychotropic medication at some point during study participation.
CONCLUSIONS: Opioid agonist-treated pregnant patients with co-occurring symptoms of anxiety require additional clinical resources to prevent premature discontinuation.
Предметные рубрики MeSH
AdolescentAdultAnalgesics, OpioidAnxietyBuprenorphineComorbidityDepressionDouble-Blind MethodFemaleHumansInterview, PsychologicalLogistic ModelsMethadoneOpiate Substitution TreatmentOpioid-Related DisordersPatient CompliancePregnancyPregnancy ComplicationsPregnancy OutcomeSeverity of Illness IndexTreatment OutcomeYoung Adult