Аннотация:
Background. Psychoactive substances have always occupied such a place in society, the abuse of which has always been one of the most pressing challenges for the entire world community, especially when it was detected and observed in mentally ill people. The number of such patients who had psychiatric and narcological diagnosis increases from year to year. But despite all this, this problem remains poorly studied. This study attempted to analyze such comorbidity.
Aim. To carry out an analysis and make a prognosis of affective disorders in patients with opioid use disorder.
Methods. The study was carried out on the basis of the Moscow scientific and practical center of narcology (MSaPCoN). The research was conducted on 122 hospitalized patients (75 men and 47 women) aged 18 to 55 years (mean age 34.58 ± 0.15 years), with opioid use disorder, in whose mental status the leading or significant place was occupied by affective disorders, who were treated at the MSaPCoN in 2015–2016 and participated in the study "Affective disorders in patients with opioid use disorder". A special survey card was filled out for each respondent, which included gender, working status, marital status, changes in character, the presence/absence of depression and their types, the severity of the depth of depression, the factors determining depression, the dependence of the affective background on the season of the year, opioid use disorder.
Results. Seasonal rhythm of affect was found to be predominant in the group with melancholy and apathy (p=0.00267). For the group, where anxiety and dysphoria were predominant, seasonal rhythmic affect was mostly not detected (OR = 5.417; 95% CI 1.249-23.489). Based on this, it can be assumed that in the group with melancholy and apathy, the formation of the affective component of the depressive spectrum had an endogenous sub-basis. And the group with anxiety and dysphoria in its structure of formation of affective disorders had a narcogenic basis. Continued use revealed that the predominant type of affect for this group (p=0.01689) was represented by anxiety and dysphoria, and in the group where remission was noted for this indicator, melancholy and apathy, mania prevailed (OR = 10.313; 95% CI 1.183-89.866). Based on the data obtained, it can be assumed that the group where there was an endogenous predisposition of the formation of affective disorders had a greater probability of forming remission than the group that was represented by an affective response with a narcogenic potential. The prognosis of the disease (p=0.00484) was found to be more favorable in the groups with mania, melancholy and apathy (OR = 7.04; 95% CI 1.638-30.256). That is, the endogenous component in the affective disorder, which in this study was presented by the mixed variant (endogeny+narcogeny), is more favorable in terms of the prognosis of remission than the affective disorder, which is due only to the narcogenic potential.
Conclusion. Endogenous predisposition of affective disorder formation in patients with opioid use disorder had a greater probability of remission formation and had a more favorable prognosis than the group that was represented by affective response with narcogenic potential.
Ключевые слова:
melancholy and apathy, anxiety and dysphoria,endogenous, narcogenic.