Depression as a Risk Factor for Relapse After Inpatient Opioid Detoxification: 1-Year Follow-Up Study

Abstract

Background: Opioid dependence is a complicated disorder in which multiple factors interact to influence initiation of use, repeated use, addiction, and relapse. Negative emotional states, such as anger, anxiety, depression, frustration, and boredom are also associated with the highest rate of relapse Objectives:: The researchers of the current study propose that depression is a significant risk factor for relapse after inpatient detoxification, for which they conducted this 1-year follow up study to compare relapsed with non-relapsed patient group with respect to their depressive symptoms. Patients and Methods: A total of 581 patients were admitted to the tertiary care institute of the current study from 1st of January 2014 to 31st of December 2015, out of which 115 subjects met the defined exclusion criteria or did not meet the inclusion criteria. The remaining 466 patients were considered for the study. All the patients were followed up for relapse and interviewed with the 24-item Hamilton Depression Rating Scale (HAM-D) every 2 weeks for the next 1 year. Relapsed and non-relapsed groups were compared. Results: No significant difference was found between relapsed and non-relapsed patients regarding their socio-demographic profile. In a comparison between relapsed and non-relapsed group, though both groups showed high mean depression score throughout the 1-year follow up, the relapsed group had a much higher score, almost double that of the other group. Very severe depression was seen in more than 16% of relapsed patients, which was absent in non-relapsed patients. Conclusions: The current study found persistent high mean depression scores after inpatient detoxification in both groups. Regular screening for depression is needed during post-detoxification follow up period as timely intervention may prevent relapse.