Depression and other psychological health problems among methamphetamine dependent patients in treatment: Implications for assessment and treatment outcome

Abstract

Amphetamines are second to cannabis as the most prevalent illicit drug used in Australia, and amphetamine abuse and dependence are associated with significant health and psychosocial harms. The current paper presents a series of studies investigating the prevalence of depression and other psychological problems among Western Australian patients receiving treatment for methamphetamine dependence. In the first study, a medical case-note audit explored the psychological profile among 218 consecutive admissions to an inpatient methamphetamine detoxification program. In the second study, the Beck Depression Inventory (BDI-II, Beck, Steer, & Brown, 1996) was administered to 367 patients receiving outpatient treatment for methamphetamine or heroin dependence (Phase 1), and the relationship between scores on the BDI-II and methamphetamine intoxication was explored (Phase 2). High rates of depression and other psychological problems were identified. Approximately 46% of methamphetamine-dependent individuals entering an inpatient treatment unit had been previously diagnosed for a psychological health problem, with approximately 30% requiring admission into a psychiatric hospital. In the second study, the mean total BDI-II score was approximately 22, which is in the moderate range of depression. Methamphetamine-dependent patients' total BDI-II score was similar to that of psychiatric outpatients with clinical depression, but significantly greater than college students and psychiatric outpatients with anxiety disorders (Beck et al., 1996). Methamphetamine use was associated with responses on the BDI-II corresponding with cognitive symptoms, whereas combined methamphetamine and heroin use was associated with responses indicating problems in the somatic domain. Finally, it was found that methamphetamine intoxication at the time of testing, as indicated by a positive saliva methamphetamine screen, affected responses to the BDI-II. These data demonstrate that methamphetamine-dependent individuals will present with significant psychological symptoms that may affect the response to treatment for drug dependence.