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Prevalence and Predictors of Symptoms of Depression Among Individuals Seeking Treatment from Australian Drug and Alcohol Outpatient Clinics

  • Breanne HobdenEmail author
  • Mariko Carey
  • Jamie Bryant
  • Rob Sanson-Fisher
  • Christopher Oldmeadow
Original Paper
  • 13 Downloads

Abstract

This study examined the prevalence of and sociodemographic characteristics associated with elevated symptoms of depression among clients seeking alcohol or other drug (AOD) treatment. Consenting clients attending two AOD outpatient clinics answered demographics, treatment questions and the Patient Health Questionnaire to assess depressive symptoms. Counts and percentages were calculated to determine the prevalence of elevated depressive symptoms. Logistic regression was used to model the odds of having elevated depressive symptoms for client demographics. Of the 203 clients who completed the survey (87% consent rate), 55% (n = 111) demonstrated elevated depressive symptoms. Females were twice as likely to experience elevated symptoms of depression compared to males (OR 2.07; 95% CI 1.05, 4.08; P = 0.037). The high rates of elevated depressive symptoms among individuals seeking AOD treatment highlight the importance of ongoing research to provide effective treatments for this comorbidity. Routine screening and clear treatment pathways may assist with providing high quality care.

Keywords

Mental health Substance-related disorders Mood disorders Population characteristics 

Notes

Acknowledgements

This work was supported by a grant from the National Health and Medical Research Council (NHMRC) (1073031). Ms. Breanne Hobden is supported by an Australian Rotary Health, Ian Scott Mental Health PhD Scholarship (G1401254). Dr. Mariko Carey is supported by a National Health and Medical Research Council Translating Research into Practice Fellowship (1073031). Dr. Jamie Bryant is supported by an Australian Research Council Post-Doctoral Industry Fellowship (1105809). The researchers would like to thank the staff at the AOD clinics.

Author Contributions

All authors certify responsibility for this manuscript, as outlined by the Community Mental Health Journal.

Compliance with Ethical Standards

Conflicts of interest

The authors have no conflicts of interest to declare.

Ethical Approval

The Hunter New England Human Research Ethics Committee (15/06/17/4.02) and the University of Newcastle (H-2015-0414) granted full ethical approval for this research. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Baker, A., Lee, N., Claire, M., Lewin, T., Grant, T., Pohlman, S., et al. (2004). Drug use patterns and mental health of regular amphetamine users during a reported ‘heroin drought’. Addiction, 99(7), 875–884.CrossRefGoogle Scholar
  2. Berk, M., Hallam, K., Malhi, G., Henry, L., Hasty, M., Macneil, C., et al. (2010). Evidence and implications for early intervention in bipolar disorder. Journal of Mental Health, 19, 113–126.CrossRefGoogle Scholar
  3. Bilsker, D., & White, J. (2011). The silent epidemic of male suicide. BCMJ, 53(10), 529–534.Google Scholar
  4. Burgess, P., Pirkis, J., Slade, T., Johnston, A., Meadows, G., & Gunn, J. (2009). Service use for mental health problems: Findings from the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 43, 615–623.CrossRefGoogle Scholar
  5. Burns, L., Teesson, M., & O’Neill, K. (2005). The impact of comorbid anxiety and depression on alcohol treatment outcomes. Addiction, 100(6), 787–796.CrossRefGoogle Scholar
  6. Chan, Y.-F., Dennis, M., & Funk, R. (2008). Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment. Journal of Substance Abuse Treatment, 34(1), 14–24.CrossRefGoogle Scholar
  7. Cole, M., & Sacks, T. (2008). When dual diagnosis means no diagnosis: Co-occurring mental illness and problematic drug use in clients of alcohol and drug services in eastern metropolitan Melbourne. Mental Health and Substance Use, 1, 33–43.CrossRefGoogle Scholar
  8. Darke, S., Swift, W., & Hall, W. (1994). Prevalence, severity and correlates of psychological morbidity among methadone maintenance clients. Addiction, 89, 211–217.CrossRefGoogle Scholar
  9. Darke, S., Wodak, A., Hall, W., Heather, N., & Ward, J. (1992). Prevalence and predictors of psychopathology among opioid users. British Journal of Addiction, 87, 771–776.CrossRefGoogle Scholar
  10. Davis, L., Frazier, E., Husain, M., Warden, D., Trivedi, M., Fava, M., et al. (2006). Substance use disorder comorbidity in major depressive disorder: A confirmatory analysis of the STAR*D cohort. Am J Addict, 15, 278–285.CrossRefGoogle Scholar
  11. Deane, F., Kelly, P., Crowe, T., Coulson, J., & Lyons, G. (2013). Clinical and reliable change in an Australian residential substance use program using the addiction severity index. Journal of Addictive Diseases, 32, 194–205.CrossRefGoogle Scholar
  12. Delgadillo, J., Payne, S., Gilbody, S., Godfrey, C., Gore, S., Jessop, D., et al. (2011). How reliable is depression screening in alcohol and drug users? A validation of brief and ultra-brief questionnaires. Journal of Affective Disorders, 134(1–3), 266–271.CrossRefGoogle Scholar
  13. Dingle, G., & King, P. (2009). Prevalence and impact of co-occurring psychiatric disorders on outcomes from a private hospital drug and alcohol treatment program. Mental Health and Substance Use, 2, 13–23.CrossRefGoogle Scholar
  14. Dore, G., Mills, K., Murray, R., Teesson, M., & Farrugia, P. (2012). Post-traumatic stress disorder, depression and suicidality in inpatients with substance use disorders. Drug and Alcohol Review, 31, 294–301.CrossRefGoogle Scholar
  15. Dum, M., Pickren, J., Sobell, L., & Sobell, M. B. (2008). Comparing the BDI-II and the PHQ-9 with outpatient substance abusers. Addictive Behaviors, 33(2), 381–387.CrossRefGoogle Scholar
  16. Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J. L., et al. (2013). Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Medicine, 10(11), e1001547.CrossRefGoogle Scholar
  17. Freeman, A., Tyrovolas, S., Koyanagi, A., Chatterji, S., Leonardi, M., Ayuso-Mateos, J., … Haro, J. (2016). The role of socio-economic status in depression: Results from the COURAGE (aging survey in Europe). BMC Public Health, 16, e1098.Google Scholar
  18. Hepner, K. A., Hunter, S. B., Edelen, M. O., Zhou, A. J., & Watkins, K. (2009). A comparison of two depressive symptomatology measures in residential substance abuse treatment clients. Journal of Substance Abuse Treatment, 37(3), 318–325.CrossRefGoogle Scholar
  19. Hoebel, J., Maske, U., Zeeb, H., & Lampert, T. (2017). Social inequalities and depressive symptoms in adults: The role of objective and subjective socioeconomic status. PLoS ONE, 12, e0169764.CrossRefGoogle Scholar
  20. Hood, S., & O’Neil, G. H. G. (2009). The role of flumazenil in the treatment of benzodiazepine dependence: Physiological and psychological profiles. Journal of Psychopharmacology, 23, 401–409.CrossRefGoogle Scholar
  21. Jenkins, R. (2007). Substance use and suicidal behaviour. Psychiatry, 6(1), 16–18.CrossRefGoogle Scholar
  22. Johns, K., Baker, A., Webster, R., & Lewin, T. (2009). Factors associated with retention in a long-term residential rehabilitation programme for women with substance use problems. Mental Health and Substance Use, 2, 40–51.CrossRefGoogle Scholar
  23. Johnston, A., Pirkis, J., & Burgess, P. (2009). Suicidal thoughts and behaviours among Australian adults: Findings from the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 43, 635–643.CrossRefGoogle Scholar
  24. Kingston, R. E. F., Marel, C., & Mills, K. (2016). A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug and Alcohol Review.  https://doi.org/10.1111/dar.12448.Google Scholar
  25. Kroenke, K., Spitzer, R., & Williams, J. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.CrossRefGoogle Scholar
  26. Lai, H. M., Cleary, M., Sitharthan, T., & Hunt, G. E. (2015). Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: A systematic review and meta-analysis. Drug and Alcohol Dependence, 154, 1–13.CrossRefGoogle Scholar
  27. Lejoyeux, M., & Lehert, P. (2011). Alcohol-use disorders and depression: Results from individual patient data meta-analysis of the acamprosate-controlled studies. Alcohol and Alcoholism, 46(1), 61–67.CrossRefGoogle Scholar
  28. Lubman, D., Allen, N., Rogers, N., Cementon, E., & Bonomo, Y. (2007). The impact of co-occurring mood and anxiety disorders among substance-abusing youth. Journal of Affective Disorders, 103, 105–112.CrossRefGoogle Scholar
  29. Marel, C., Mills, K., Kingston, R., Gournay, K., Deady, M., Kay-Lambkin, F., … Teesson, M. (2016). Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings. Retrieved from Sydney, Australia.Google Scholar
  30. Martin, L., Neighbors, H., & Griffith, D. (2013). The experience of symptoms of depression in men vs women: Analysis of the National Comorbidity Survey Replication. JAMA Psychiatry, 70(10), 1100–1106.CrossRefGoogle Scholar
  31. McKetin, R., Lubman, D., Lee, N., Ross, J., & Slade, T. (2011). Major depression among methamphetamine users entering drug treatment programs. Medical Journal of Australia, 195, S51–S55.CrossRefGoogle Scholar
  32. Mortlock, K., Deane, F., & Crowe, T. (2011). Screening for mental disorder comorbidity in Australian alcohol and other drug residential treatment settings. Journal of Substance Abuse Treatment, 40, 397–404.CrossRefGoogle Scholar
  33. Nunes, E., & Levin, F. (2004). Treatment of depression in patients with alcohol or other drug dependence: A meta-analysis. JAMA, 291(15), 1887–1896.CrossRefGoogle Scholar
  34. Riolo, S., Nguyen, T., Greden, J., & King, C. (2005). Prevalence of depression by race/ethnicity: Findings from the National Health and Nutrition Examination Survey III. American Journal of Public Health, 95(6), 998–1000.CrossRefGoogle Scholar
  35. Ross, J., Teesson, M., Darke, S., Lynskey, M., Ali, R., Ritter, A., et al. (2005). The characteristics of heroin users entering treatment: Findings from the Australian Treatment Outcome Study (ATOS). Drug and Alcohol Review, 24, 411–418.CrossRefGoogle Scholar
  36. Stafford, M., Jackson, H., Mayo-Wilson, E., Morrison, A., & Kendall, T. (2013). Early interventions to prevent psychosis: Systematic review and meta-analysis. BMJ, 346, f185.CrossRefGoogle Scholar
  37. Staiger, P., Thomas, A., Ricciardelli, L., & McCabe, M. (2011). Identifying depression and anxiety disorders in people presenting for substance use treatment. Medical Journal of Australia, 195, S60–S63.Google Scholar
  38. Teesson, M., Slade, T., & Mills, K. (2009). Comorbidity in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 43(7), 606–614.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and MedicineUniversity of NewcastleCallaghanAustralia
  2. 2.Priority Research Centre for Health BehaviourUniversity of NewcastleCallaghanAustralia
  3. 3.Hunter Medical Research InstituteNew Lambton HeightsAustralia
  4. 4.Public Health Stream, Hunter Medical Research InstituteNew Lambton HeightsAustralia
  5. 5.Centre for Clinical Epidemiology and BiostatisticsUniversity of NewcastleCallaghanAustralia
  6. 6.Health Behaviour Research GroupCallaghanAustralia

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