Perceived need for depression treatment among persons entering inpatient opioid detoxification

Abstract

Background and objectives: Depression is common among persons with opioid use disorder. We examined the perceived need for depression treatment (PNDT) among opioid-dependent patients and the relationship of PNDT to depression screening result.

Methods: Between May and December 2015, we surveyed consecutive persons (n = 440) seeking inpatient opioid detoxification. We used the Patient Health Questionnaire-2 (PHQ-2) to screen for depression. To assess perceived need for depression services, participants were asked, "Do you believe you should be treated for depression?" Response options were recorded into four categories: "Not Depressed (ND)," "Perceive Need for Depression Treatment (PNDT)," "Depressed/Don't Want Treatment," and "Currently Treated."

Results: Participants' mean age was 32.3 (±8.7) years; 70.7% were male. Nearly two out of three persons screened positive for depression yet only 8.2% were being treated for depression prior to admission. Screening positive for depression was associated with a 2.95 (95%CI 1.82-4.81, p < .005) fold increase in the expected odds of PNDT. But nearly half of those depressed (48%) did not perceive the need for treatment. Approximately 40% of the participants (n = 177) perceived that they were not depressed; of these persons, 52% screened positive for depression.

Discussion and conclusions: Detoxification program staff should screen patients for depression, and if a clinical diagnosis is confirmed, discuss treatment options, exploring the level of interest in mental health treatment for depression.

Scientific significance: Screening for and addressing depression, including patients' interest in treatment, should be central to post-detoxification aftercare planning. (Am J Addict 2017;26:395-399).