Abstract
ObjectiveThe objective of the study was to describe psychological features of abstinent heroin users undergoing rehabilitation in Saint Petersburg, Russia. Study subjects (n = 197) were recruited prospectively at the time of their admission to rehabilitation between March 2010 and May 2011 at 7 inpatient opiate addiction rehabilitation centers in Saint-Petersburg and neighboring regions, Russia. The centers provided varying rehabilitation programs; 6 of them were religious centers. Socio-demographic information and self-reported HIV status were collected. Personality profiles and severity of drug-associated problems were estimated before and after rehabilitation using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and the Addiction Severity Index (ASI).ResultsThirty-three (17%) subjects dropped out before completing rehabilitation (non-completers). All subjects (completers and non-completers) had psychopathological personality profiles according to MMPI-2. These profiles were refractory to clinically significant improvement after rehabilitation, although some statistically significant changes toward improvement were observed. ASI scores showed statistically and clinically significant improvements after rehabilitation on all scales. Participants in longer-term versus shorter-term rehabilitation programs showed similar changes in their pre- and post-rehabilitation MMPI-2 and ASI scores. Our results suggest that unmet psychiatric needs should be addressed to potentially improve treatment completion in this population.
Highlights
Of the estimated 11–21 million people who inject drugs (PWID) in the world, many reside in China, the United States, the Russian Federation, and Brazil, which together account for an estimated 45% of the worldwide population of PWID [1, 2]
All subjects had psychopathological personality profiles according to Minnesota Multiphasic Personal‐ ity Inventory (MMPI)-2
Pre- and post-rehabilitation Addiction Severity Index (ASI) scores showed statistically and clinically significant improvements on Discussion It has been shown in previous publications that PWIDs can often be subdivided into several psychologically distinct subgroups representing psychologically distinct subpopulations who may differ in their pathogenesis of addiction, response to treatment and prognosis [11–14]
Summary
All rehabilitation clients who were invited to participate agreed to join the study. The study participants were 197 Caucasian adults (144 males, 53 females), ranging in age from 16 to 59 (Additional file 1: Table S1 and Additional file 2: Table S2). Of the 197 participants, 33 (17%) dropped out of their rehabilitation programs These non-completers did not have any distinctions in socio-demographic variables (Additional file 1: Table S1 and Additional file 2: Table S2) or in MMPI-2 profile (MANOVA’s F = 0.93, p = 0.51, see Fig. 1). The rate of non-completion (number of noncompleters/total time of rehabilitation) was the same: 4.3 non-completers per 100 patients per month (30 days) in shorter-term programs and 4.4 non-completers per 100 patients per month in longer-term programs (p = 1.00, Poisson test). Comparing pre- and post-rehabilitation scores, MMPI-2 results showed a subtle, but statistically significant, reduction in all clinical scales except for the Mascale, reduction in the F-scale, and an increase in the K and L scales (MANOVA’s F = 56.6, p < 0.0001, see Fig. 1). Pre- and post-rehabilitation ASI scores showed statistically and clinically significant improvements on
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