Characteristics of depression, anxiety, impulsivity, and aggression among various types of drug users and factors for developing severe depression: a cross-sectional study

Abstract

Background: Mood disorder, impulsivity and aggression are common in drug users compared to healthy controls. However, no study has focused on the difference in various types of drug users. Therefore, the objective of this study was to explore the differences in depression, anxiety, impulsivity, and aggression among methamphetamine, heroin and polysubstance users and to further explore the risk factors for severe depression in the three groups.

Methods: Drug users over 18 years old who met the DSM-V diagnostic criteria for substance -related disorders were included in the study. All participants completed a general questionnaire, the Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS), Barratt impulsiveness Scale Version 11 (BIS-11), and the Buss-Perry Aggression Questionnaire (BPAQ). One-way ANOVAs or Chi-square tests were used to test the differences among the groups, correlation analysis was used to test the relationship between drug use and other parameters, and multiple logistic regression was conducted to assess the risk factors for severe depression.

Results: A total of 1,486 participants were included, comprising 86.3% males with a mean age of 38.97 years. There was a significant difference in the percentage of severe depression and SDS scores among the three groups, but no significant difference was found in SAS, BIS-11 and BPAQ scores. Using methamphetamines, hostility and anxiety were risk factors for developing severe depression in all the participants and anxiety remained constant in the other three groups. Moreover, methamphetamine use was 2.16 and 3.35 times more likely to cause severe depression than heroin and polysubstance use, respectively. The initial age of substance use was negatively correlated with BPAQ, SAS, and SDS scores, whereas the drug use duration and addiction duration were positively correlated.

Conclusions: In this study, we found that the highest prevalence of severe depression was in participants using methamphetamines and that using methamphetamines, hostility, and anxiety were risk factors for developing severe depression. This result addressed an important gap in our knowledge of the different characteristics of depression, anxiety, impulsivity and aggression in various types of substance users and provides clinicians and policy-makers with directions for intervention and preventing relapse.

Keywords: Aggression; Heroin; Impulsivity; Methamphetamine; Severe depression.

Fig. 1

Flowchart of the study

Fig. 2

Differences of in BIS-11, BPAQ, SDS, and SAS scores among the methamphetamine-only, heroin-only, and polysubstance groups. BIS-11 Barratt impulsiveness scale version 11, VA verbal aggression, PA physical aggression, BPAQ Buss-Perry aggression questionnaire, SDS Zung Self-Rating Depression Scale, SAS Zung Self-Rating Anxiety Scale, ns no significance. *p < 0.05 by one-way ANOVA

Fig. 3

Correlations between substance use and impulsivity, aggression, anxiety and depression. VA verbal aggression, PA physical aggression, BPAQ Buss-Perry aggression questionnaire, AI attention impulsivity, MI motor impulsivity, NPI nonplanning impulsivity, BIS-11 Barratt impulsiveness scale version 11, SDS Zung Self-Rating Depression Scale, SAS Zung Self-Rating Anxiety Scale. *p < 0.05, **p < 0.01, ***p < 0.001