Аннотация:
Introduction. Motivation for treatment is a complex, multifaceted phenomenon that impacts the effectiveness of medical treatment patients receive with opioid use disorder (OUD). However, the set of factors, which determine the readiness for treatment in patients with OUD has not been sufficiently studied.
Aim: to assess the role of socio-demographic, clinical and psychoemotional characteristics in motivation for treatment in patients with OUD.
Methods. This cross-sectional study included 129 patients with OUD (F11.20; F11.21 according to ICD-10). The following methods have been used: Stages of change readiness and treatment eagerness scale (SOCRATES), the Differential Emotions Scale (DES), Hamilton Rating Scale for Depression (HDRS), Anticipatory Consistency (TASPK), Purpose-in-life Test (PIL), Toronto Alexithymia Scale (TAS 26).
Results. The patients’ median age was 24,0 years old [18,0; 35,0]. The participants with high motivation for treatment (HMT), as compared to the patients with average motivation for treatment (AMT) and low motivation for treatment (LMT), were more likely to have skilled employment and be married (p≤0,05). The participants with LMT tended to have a poor relationship with the father more often and a good relationship with relatives less often (p≤0,05). The family members of participants with LMT and AMT demanded stop using psychoactive substances less often (p≤0,05). The patients with LMT were young compared to patients with LMT and HMT, had a shorter duration of OUD and withdrawal symptoms, less treatment in the past and the duration of abstinence after treatment, a lower ratio of the duration of abstinence to the duration of the disorder (p≤0,05). The participants with HMT reported experiencing greater emotions of "interest", "personal-situational anticipatory consistency", "the purpose in life", "life process" as compared to LMT; at the same time, they displayed lower alexithymia and higher "locus of control – Me" as compared to LMT and AMT (p≤0,05). The regression analysis of the obtained data determined the following predictors for the readiness for treatment (SOCRATES): the ratio of the duration of abstinence to the duration of the disorder (В1 = 87,67), "interest" (DES) (В2 = 1,12), "alexithymia" (ТАС 26) (В3 = –0,30), gender (male, female) (В4 = –7,46), awareness of the disease (В5 = 1,74), time of the last use of opioids (В6 = –0,69)
(B0 = 80,89; adjusted R2 = 0,79).
Conclusion. The presence of positive social and clinical characteristics, the awareness of the disease, the goals in life, higher level of interest and lower Alexithymia, emotional richness in life, and the ability to anticipate conflictual situations in relationship increase motivation for treatment in patients with OUD.
Ключевые слова:
opioid use disorder, motivation for treatment, emotions, clinical and social factors.