The impact of depression on the outcome of addictions treatment

FRANÇAIS :
Cet article examine la prévalence et le type d'état dépressif parmi des patients souffrant de troubles de la consommation de substance pour mieux apprécier les effets de la dépression sur les résultats d'un traitement d'addiction. L'évaluation, à l'aide d'entretiens cliniques et semi-structurés (Hamilton Rating Scale for Depression, Global Assessment Scale, Beck Depression Inventory), de 75 patients admis en traitement montre 22,4% de patients souffrant de troubles dépressifs antérieurs à leur consommation, 8,4% de dépressions dues aux substances et 5,6% des deux (ce dernier cas touche plus les femmes et les alcooliques). Après 3 mois, une nouvelle évaluation laisse apparaître une plus longue période d'abstinence et une diminution des symptômes dépressifs chez les patients dépressifs et un abandon presque complet de l'usage de substance chez les patients dont la dépression est due aux substances. La dépression semble donc agir sur les résultats des traitements, mais d'autres facteurs doivent être identifiés.
ENGLISH :
The objectives of this study were to examine the prevalence and presentation of depression among patients with substance use disorders, and to explore the relationship between depression and the outcome of addictions treatment. 75 patients were consecutively recruited upon entering addictions treatment, and were assessed by clinical and semi-structured interviews (Hamilton Rating Scale for Depression, Global Assessment Scale, Beck Depression Inventory). 22, 4% of patients had primary depressive disorders, 8,4% had substanceinduced depresssions, and 5,6% had mixed features of primary and substance-induced depressions (more likely female and alcoholic patients for these both depressions). At 3 months, 93,3% of patients were reinterviewed. Depressed patients had longer duration of abstinence and greater decreases in symptomatology. Patients with substance-induced depression achieved almost complete discontinuation of primary substance use. Depression had a significant impact on addictions treatment outcome, but many important predictors of outcome have not yet been identified. (from authors'abstract)