Psychiatric Comorbidity and Gender Effects in Heroin and Cocaine-Addicted Patients in Specified Long-Term Treatment and Acute Inpatient Detoxification Treatment

Objective: Previous reports on heroin and cocaine addicts showed drug-related and gender differences in psychiatric comorbidity, which has relevant consequences for treatment. However, studies vary substantially with respect to methods and timeframes. Studies on German patient groups are scarce. Methods: Data on psychiatric and somatic comorbidity, substance addiction history, present intake patterns and sociodemography were obtained from 43 female (n=11) and male (n=32) heroin and cocaine addicts in acute inpatient detoxification treatment or specified long-term treatment. A European Addiction-Severity-Index (EuropASI) based centre questionnaire and the Mini-DIPS were applied. Results: Treatment groups did not differ in psychiatric comorbidity. Female subjects, however, had a significantly higher prevalence of psychiatric comorbid diagnoses (p<.05), mostly anxiety and affective disorders which significantly correlated with low occupational status (p<.05).Patients in long-term treatment abused more other substances and had an earlier onset of regular substance abuse (in particular alcohol and cannabis) (p<.05). Conclusion: Heroin and cocaine addicted females are more likely than males to have affective and anxiety disorders. Long-term treatment attenders appear to be more severely addicted (earlier onset and additional abuse) than acute treatment patients but do not differ in comorbidity. However, no axis-II diagnoses were recorded and the sample-size was small. Results should be regarded as preliminary (German J Psychiatry 2009; 12: 1-7).