Relations among psychopathology, substance use, and physical pain experiences in methadone-maintained patients

J Clin Psychiatry. 2009 Sep;70(9):1213-8. doi: 10.4088/JCP.08m04367. Epub 2009 Jul 14.

Abstract

Objective: Differences in psychiatric distress and substance use (licit and illicit) were examined in methadone maintenance treatment (MMT) patients with a variety of pain experiences.

Method: Parametric and nonparametric statistical tests were performed on data obtained from 150 patients currently enrolled in MMT. Assessments were carried out at the 3 opioid agonist treatment programs operated by the APT Foundation, New Haven, Connecticut. Participants were recruited between March 2007 and March 2008.

Results: In comparison to MMT patients reporting no pain in the previous week, those with chronic severe pain (CSP) (ie, pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) exhibited significantly higher (P < .01) levels of depression, anxiety, somatization, overall psychiatric distress, and personality disorder criteria but reported comparable rates of substance use. A third group, ie, non-CSP MMT patients reporting some pain in the past week, differed significantly (P < .05) from the other 2 pain groups on somatization and global psychiatric distress but reported comparable rates of substance use.

Conclusions: Pain-related differences in psychiatric problems exist in MMT patients and may have implications for program planning and outreach efforts.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Disease
  • Comorbidity
  • Connecticut / epidemiology
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Methadone / therapeutic use*
  • Middle Aged
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / rehabilitation
  • Pain / diagnosis
  • Pain / epidemiology*
  • Pain Measurement / statistics & numerical data
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology
  • Personality Inventory
  • Prevalence
  • Severity of Illness Index
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / epidemiology
  • Substance Abuse Treatment Centers
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / rehabilitation*
  • Surveys and Questionnaires

Substances

  • Methadone