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Quality of life in a community sample of young cocaine and/or heroin users: the role of mental disorders

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Abstract

Purpose

Drug addiction and psychiatric disorders are frequently concomitant; however, few studies have investigated the impact of psychiatric disorders other than substance use disorder (SUD) on health-related quality of life (HRQoL) in drug users not in treatment. We studied the association of psychiatric disorders other than SUD with HRQoL in a street-recruited sample of cocaine and/or heroin users.

Methods

It is a cross-sectional study involving 287 young users of cocaine and/or heroin in Barcelona, Spain. HRQoL was assessed with the Nottingham health profile (NHP). Patterns of drug use and mental disorders were assessed using the Spanish version of the psychiatric research interview for substance and mental disorders IV, and degree of dependence through the severity of dependence scale (SDS). The association of mental disorders with HRQoL was assessed through a Tobit regression analysis.

Results

The overall NHP score was 23.9 (SD = 20.5, range 0–91.7). Sixty-one percent of the sample had two or more SUDs; 22 % had at least one non-SUD Axis I disorder (anxiety, mood, psychotic, or eating disorder); and 27.2 % had a borderline personality disorder (BPD) and/or antisocial personality disorder. Variables negatively associated with the global NHP score were psychosis [transformed beta coefficient: 15.23; 95 % confidence interval [CI] 4.48–25.97], BPD (9.55; 95 % CI 2.95–16.15), severity of dependence (8.12; 95 % CI 3.37–12.87), having two or more SUDs (for two or three SUDs: 6.83; 95 % CI 2.08–11.59) (>3 SUDs: 7.70; 95 % CI 1.72–13.68) and the intravenous use of some substance (10.20; 95 % CI 6.00–14.40).

Conclusion

HRQoL among street-recruited illegal substance users was impaired, particularly among those with psychiatric comorbidity, psychosis, and BPD being especially relevant.

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Acknowledgments

We gratefully acknowledge the contribution of all the participants and of those institutions that were involved in recruitment: ABD, Spott, Ambit, CECAS, Secretaria de Serveis Penitenciaris, Rehabilitació i Justícia Juvenil. We also thank the Escuela Nacional de Sanidad-ISCIII for facilitating infrastructure and logistic resources for the preparation of this manuscript and to Laura Ortiz Zalama for English translation and Dave Macfarlane for revision. The field work was financed by Fundación para la Investigación y la Prevención del Sida en España (Fipse 486 3035/99) and Plan Nacional Sobre Drogas (PNSD 2001 and 2004). The analysis and writing of this article was made possible by grants EPY-020/029 (ISCIII) and RD06/0001/1018, and (RTA) RD12/0028/0018 and RD12/0028/0009. Further financial support was provided by the Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR 2009 SGR 718). Albert Sánchez-Niubò was supported by the Instituto de Salud Carlos III Grant No. CA08/00214.

Ethical standard

The study was approved by the institution ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

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Authors and Affiliations

  1. Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain

    M. Chahua

  2. Drug Abuse Epidemiology Research Group, IMIM-Hospital del Mar, Dr Aiguader 88, 08002, Barcelona, Spain

    A. Sánchez-Niubò & A. Domingo-Salvany

  3. Addiction Research Group, IMIM-Hospital del Mar, Barcelona, Spain

    M. Torrens

  4. Department of Psychiatry, Universitat Autònoma de Barcelona, Catalonia, Spain

    M. Torrens

  5. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain

    L. Sordo & M. J. Bravo

  6. Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

    L. Sordo

  7. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    L. Sordo & M. J. Bravo

  8. Agència de Salut Pública de Barcelona, Barcelona, Spain

    M. T. Brugal

  9. Institut d’Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain

    M. T. Brugal

Authors
  1. M. Chahua
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  2. A. Sánchez-Niubò
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  3. M. Torrens
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  4. L. Sordo
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  5. M. J. Bravo
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  6. M. T. Brugal
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  7. A. Domingo-Salvany
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the ITINERE Project Group

Corresponding author

Correspondence to A. Domingo-Salvany.

Additional information

The ITINERE Project Group: Luis De la Fuente, Gemma Molist, Rosario Ballesta, Gregorio Barrio, Yolanda Castellano, Fermín Fernández, Daniel Lacasa, José Pulido, Fernando Vallejo, Albert Espelt, Mireia Ambrós, Ana Sarasa-Renedo, MJ Herrero, Blanca Iciar Indave, and MC Rodriguez-Llera.

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Chahua, M., Sánchez-Niubò, A., Torrens, M. et al. Quality of life in a community sample of young cocaine and/or heroin users: the role of mental disorders. Qual Life Res 24, 2129–2137 (2015). https://doi.org/10.1007/s11136-015-0943-5

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