Abstract
BackgroundBoth stigma and psychological distress affect quality of life (QOL). This study is an attempt to determine the effects of these two factors on QOL and to explore possible mediation effects between psychological distress and self-stigma in opioid-dependent individuals.MethodsThis cross-sectional study comprised 268 consecutive, treatment-seeking opioid-dependent individuals who were interviewed using the brief version of the World Health Organization Quality of Life instrument (WHOQOL-BREF), the Self-Stigma Scale-Short (SSS-S), the Chinese Health Questionnaire-12 (CHQ-12), and the Opiate Treatment Index (OTI). A series of regression models were constructed to determine if the SSS-S and CHQ-12 predict the WHOQOL-BREF scores. Moreover, a comparison of the potential mediation effects of psychological distress (as assessed by the CHQ-12) was made between the SSS-S and the WHOQOL-BREF using the Baron and Kenny procedure (including three separate regressions), along with the Sobel test.ResultsThe CHQ-12 score was predictive of the scores for the four domains and almost all facets of the WHOQOL-BREF except the item, “Dependence on medical aids.” Nonetheless, the SSS-S score predicted three of the four facets of the social QOL after adjustment of the CHQ-12 score. Psychological distress completely mediated the relation between self-stigma and the physical, psychological, and environmental domains, and partially mediated the relationship between self-stigma and social QOL (two-tailed Sobel test: p = 0.02 for each domain).ConclusionsPsychological distress has a significant impact on the QOL of treated opioid users. It appears to be a core element in reducing the negative effects of self-stigma on aspects of QOL.
Highlights
Psychological distress is quite common in opioid-dependent individuals because of the frequent psychological symptoms and stressful life events that occur during drug dependency [1]
The Chinese Health Questionnaire-12 (CHQ-12) score was predictive of the scores for the four domains and almost all facets of the WHOQOL-BREF except the item, “Dependence on medical aids.”
Psychological distress has a significant impact on the quality of life (QOL) of treated opioid users
Summary
Psychological distress is quite common in opioid-dependent individuals because of the frequent psychological symptoms and stressful life events that occur during drug dependency [1]. Opioid-dependent individuals usually do not seek for medical helps because they need to pay at least US$1,000 dollars for one course of this short-term treatment It was not until 2006 that considerable changes have occurred in treatment and care structure in response to HIV epidemic; the Taiwan Center for Disease Control (CDC) began to permit methadone and publicly-funded buprenorphine for long-term treatment (at least one year) with mostly free service for HIV-infected heroin users and partial copayment. Under this circumstance, more than 60% of co-existing psychiatric disorders and about 23.4% of depressive disorders have been reported to have occurred in opioid-dependent individuals [2]. The Cronbach’s alpha was 0.895 in the current study
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