Self-Assessment And External Assessment Of Depressiveness Among Patients In Opioid Substitution Treatment

Background Opioid addicts are often affected by psychological comorbidities, especially by mood disorders such as depression. The diagnosis and treatment of depressive disorders among patients in opioid substitution treatment (OST) presents a particular challenge which bears the risk that patients with depressive symptoms remain untreated.Objective To determine the extent of depressive symptoms among OST patients, and to examine the consistency of self- and external assessments made by the patient and the respective OST physician.Methods Simultaneous questionnaire surveys in 6 OST units in Hamburg, Bremen and Kassel. The self-assessment was carried out by using the Beck Depression Inventory (BDI-II). At the same time, the OST physicians were asked to fill out the Hamilton Depression Scale (HAMD) to assess the depressive symptom load of their patients.Results OST patients are often affected by depressive symptoms and if so, often to a clinically relevant extent. A positive correlation between the instruments in 4 categories could be confirmed. Compared to the self-assessment, physicians estimated the depressive burden on their patients as less severe.Conclusion The 2 instruments used are suitable for supporting the diagnosis of depressive symptoms among patients in OST, whereby the external assessment by the OST physicians is more conservative. The results confirm the high relevance of the diagnosis of depressive symptoms among OST patients in order to initiate treatment measures if needed and in due time.