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Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2018

Open Access 01-12-2018 | Primary research

The long-term outcome of patients with heroin use disorder/dual disorder (chronic psychosis) after admission to enhanced methadone maintenance

Authors: Angelo G. I. Maremmani, Alessandro Pallucchini, Luca Rovai, Silvia Bacciardi, Vincenza Spera, Marco Maiello, Giulio Perugi, Icro Maremmani

Published in: Annals of General Psychiatry | Issue 1/2018

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Abstract

Background

Over-standard methadone doses are generally needed in the treatment of heroin use disorder (HUD) patients that display concomitant high-severity psychopathological symptomatology. A flexible dosing regimen may lead to higher retention rates in dual disorder (DD), as we demonstrated in bipolar 1 HUD patients, leading to outcomes that are as satisfactory as those of HUD patients without high-severity psychopathological symptomatology.

Objective

This study aimed to compare the long-term outcomes of treatment-resistant chronic psychosis HUD patients (PSY-HUD) with those of peers without dual disorder (HUD).

Methods

85 HUD patients who also met the criteria for treatment resistance—25 of them affected by chronic psychosis and 60 without DD—were monitored prospectively for up to 8 years while continuing to receive enhanced methadone maintenance treatment.

Results

The rates of endurance in the treatment of PSY-HUD patients were 36%, compared with 34% for HUD patients (p = 0.872). After 3 years of treatment, these rates tended to become progressively more stable. PSY-HUD patients showed better outcome results than HUD patients regarding CGI severity (p < 0.001) and DSM-IV-GAF (p < 0.001). No differences were found regarding good toxicological outcomes or the methadone dosages used to achieve stabilization. The time required to stabilize PSY-HUD patients was shorter (p = 0.034).

Conclusions

An enhanced methadone maintenance treatment seems to be equally effective in patients with PSY-HUD and those with HUD.
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Metadata
Title
The long-term outcome of patients with heroin use disorder/dual disorder (chronic psychosis) after admission to enhanced methadone maintenance
Authors
Angelo G. I. Maremmani
Alessandro Pallucchini
Luca Rovai
Silvia Bacciardi
Vincenza Spera
Marco Maiello
Giulio Perugi
Icro Maremmani
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2018
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-018-0185-3

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