Psychiatric Comorbidities among People Who Inject Drugs in Hai Phong, Vietnam: The Need for Screening and Innovative Interventions.

Khue Pham Minh,Delphine Rapoud,Jonathan Feelemyer,Jean-Pierre Moles,Vinh Vu Hai,Sao Mai Le,Catherine Quillet,Don C Des Jarlais,Xanh Pham Thu,Drive Study Team,Nicolas Nagot,Huong Duong Thi,Marianne Peries,Roselyne Vallo,Giang Hoang Thi,Didier Laureillard,Tuyet Thanh Nham Thi,Laurent Michel,Oanh Khuat Thi Hai

doi:10.1155/2018/8346195

Abstract

The objective of this study is to describe psychiatric comorbidities, associated factors, and access to psychiatric assessment and care in a cohort of people who inject drugs (PWID) in Hai Phong, Vietnam. Mental health was assessed after 12 months' follow-up using the Mini International Neuropsychiatric Interview questionnaire (MINI 5.0.0). PWID medical history, drug use, and sociodemographic and clinical characteristics were also collected. Among 188 PWID who participated in the assessment, 48 (25.5%) had at least one psychiatric disorder and 19 (10.1%) had 2 or more psychiatric disorders. The most common current psychiatric disorders were major depressive episode (12.2%) and psychotic disorder (4.8%), reaching 10.1% for the latter when lifetime prevalence was considered. Females were more likely than males to have at least one psychiatric disorder, a major depressive disorder, or an anxiety disorder. Methamphetamine use was associated with an increased risk of presenting a lifetime psychotic syndrome. Problematic alcohol consumption was associated with an increased risk of having at least one psychiatric disorder. Psychiatric comorbidities are frequent among PWID in Vietnam. These results highlight the need for routine assessment and innovative interventions to address mental health needs among PWID. Community-based interventions targeting mental health prevention and care should be strongly supported.

Highlights

People who use drugs are susceptible to mental health disorders [1,2,3], the most common being mood and anxiety disorders, suicidal ideation, and suicide attempt [2, 4]
Their main characteristics are presented in Table 1. 118 (62.8%) were currently being treated with methadone (versus 11 (4.4%) at cohort initiation), 76 (40.4%) self-reported smoking methamphetamine (92 (48.9%) on the basis of self-report and urine test), and 90 were poly drug users (47.9%), the most common being dual heroin and methamphetamine use
Using the Mini International Neuropsychiatric Interview (MINI) questionnaire, based on the DSM-IV diagnosis criteria, we found that approximately 25% of the people who inject drugs (PWID) had at least one current psychiatric disorder at the time of the study

Summary

Introduction

People who use drugs are susceptible to mental health disorders [1,2,3], the most common being mood and anxiety disorders, suicidal ideation, and suicide attempt [2, 4]. Stimulant use is associated with psychotic syndrome [5,6,7,8]. Drug users suffering from mental health disorders are more likely to engage in high-risk behaviors and have negative outcomes for the treatment of HIV infection and substance use disorders [9]. Stimulant use is associated with psychiatric complications, especially with psychotic symptoms [10], but can be associated with sexual or injection-related risk behavior and delayed access to methadone initiation for opiate dependency [11, 12]

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