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Amini Z, HeidariFarsani E. Investigating the effect of zinc supplementation on probability of relapse and mental health in patients with opioid use disorder undergoing methadone maintenance treatment. Subst Abuse Treat Prev Policy 2023; 18:1. [PMID: 36609286 PMCID: PMC9817328 DOI: 10.1186/s13011-023-00514-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Considering different factors, such as high withdrawal rates in methadone maintenance treatment (MMT) programs alongside mental health (MH) problems appearing in patients with opioid use disorder and the lack of prior research on the effect of zinc supplementation in this respect, the present study aimed to investigate the effect of zinc supplementation on the probability of relapse (PoR) and MH problems in patients with opioid use disorder undergoing MMT. METHODS For this purpose, a randomized controlled trial with a clinical basis was fulfilled on a total of 68 patients with opioid use disorder receiving MMT, allocated to two groups, viz. intervention, and control (each one consisting of 34 individuals). Then, the participants in the intervention group were given zinc supplements combined with methadone for three months, and the controls only took methadone, according to the treatment plan. The data were collected using the Relapse Prediction Scale (RPS) and the Depression, Anxiety, and Stress Scale 21 (DASS-21) before, one month after, and at the end of the intervention program. FINDINGS Compared to the control group, the likelihood of drug use (p = 0.01), drug craving (p = 0.002), and the RPS total score (p = 0.002) in the intervention group was significantly lower. Moreover, the results revealed a significant decreasing trend in depression (p = 0.01), anxiety (p < 0.001), stress (p = 0.001), and the DASS-21 total score (p = 0.001) in the intervention. Compared to the control group, the DASS-21 total score (p < 0.001) in the intervention group was significantly lower. CONCLUSION Accordingly, it was concluded that zinc supplementation could reduce the PoR and improve MH problems in patients with opioid use disorder experiencing MMT. However, further research is recommended to fill the gaps. TRIAL REGISTRATION The research protocol has also been listed on the Iranian Registry of Clinical Trials (IRCT) with code no. IRCT2020050904736N1.
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Affiliation(s)
- Zahra Amini
- grid.411036.10000 0001 1498 685XDepartment of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 8174673461 Isfahan Province Iran ,grid.411036.10000 0001 1498 685XDepartment of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ebrahim HeidariFarsani
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 8174673461, Isfahan Province, Iran. .,Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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2
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Tran HV, Nong HTT, Tran TTT, Filipowicz TR, Landrum KR, Pence BW, Le GM, Nguyen MX, Chibanda D, Verhey R, Go VF, Ho HT, Gaynes BN. Adaptation of a Problem-solving Program (Friendship Bench) to Treat Common Mental Disorders Among People Living With HIV and AIDS and on Methadone Maintenance Treatment in Vietnam: Formative Study. JMIR Form Res 2022; 6:e37211. [PMID: 35802402 PMCID: PMC9308082 DOI: 10.2196/37211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background The prevalence of common mental disorders (CMDs) among people living with HIV and people who inject drugs is high worldwide and in Vietnam. However, few evidence-informed CMD programs for people living with HIV who inject drugs have been adapted for use in Vietnam. We adapted the Friendship Bench (FB), a problem-solving therapy (PST)–based program that was successfully implemented among patients with CMDs in primary health settings in Zimbabwe and Malawi for use among people living with HIV on methadone maintenance treatment (MMT) with CMDs in Hanoi, Vietnam. Objective This study aimed to describe the adaptation process with a detailed presentation of 4 phases from the third (adaptation) to the sixth (integration) of the Assessment-Decision-Adaptation-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT) framework. Methods The adaptation phase followed a qualitative study design to explore symptoms of CMDs, facilitators, and barriers to conducting FB for people living with HIV on MMT in Vietnam, and patient, provider, and caretaker concerns about FB. In the production phase, we revised the original program manual and developed illustrated PST cases. In the topical expert and integration phases, 2 investigators (BNG and BWP) and 3 subject matter experts (RV, DC, and GML) reviewed the manual, with reviewer comments incorporated in the final, revised manual to be used in the training. The draft program will be used in the training and testing phases. Results The study was methodologically aligned with the ADAPT-ITT goals as we chose a proven, effective program for adaptation. Insights from the adaptation phase addressed the who, where, when, and how of FB program implementation in the MMT clinics. The ADAPT-ITT framework guided the appropriate adaptation of the program manual while maintaining the core components of the PST of the original program throughout counseling techniques in all program sessions. The deliverable of this study was an adapted FB manual to be used for training and piloting to make a final program manual. Conclusions This study successfully illustrated the process of operationalizing the ADAPT-ITT framework to adapt a mental health program in Vietnam. This study selected and culturally adapted an evidence-informed PST program to improve CMDs among people living with HIV on MMT in Vietnam. This adapted program has the potential to effectively address CMDs among people living with HIV on MMT in Vietnam. Trial Registration ClinicalTrials.gov NCT04790201; https://clinicaltrials.gov/ct2/show/NCT04790201
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Affiliation(s)
- Ha V Tran
- The University of North Carolina, Vietnam Office, Hanoi, Vietnam
| | - Ha T T Nong
- The University of North Carolina, Vietnam Office, Hanoi, Vietnam
| | - Thuy T T Tran
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Teresa R Filipowicz
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Kelsey R Landrum
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Giang M Le
- Center for Research and Training in HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam
| | - Minh X Nguyen
- Faculty of Epidemiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Dixon Chibanda
- Department of Community Medicine & Research Support Centre, University of Zimbabwe, Harare, Zimbabwe
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ruth Verhey
- Department of Community Medicine & Research Support Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Vivian F Go
- Department of Health Behavior, Gillings, School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Hien T Ho
- Faculty of Clinical Medicine, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
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3
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Efficacy of a Positive Psychological Intervention in Improving Mental Health Status Among Methadone Maintenance Treatment Users in Guangzhou, China—a Randomized Controlled Trial. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-019-00206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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4
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Martinez S, Jones JD, Brandt L, Hien D, Campbell AN, Batchelder S, Comer SD. Factor structure and psychometric properties of the Connor-Davidson resilience scale (CD-RISC) in individuals with opioid use disorder. Drug Alcohol Depend 2021; 221:108632. [PMID: 33621807 PMCID: PMC8026692 DOI: 10.1016/j.drugalcdep.2021.108632] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
AIMS Resilience is defined as the capacity for an individual to maintain normal functioning and resist the development of psychiatric disorders in response to stress and trauma. Although previous investigators have acknowledged the important role of resilience in those with substance use disorders, this is the first study to investigate the reliability, validity, and factor structure of the Connor-Davidson Resilience Scale (CD-RISC-25) in a sample of individuals with opioid use disorder (OUD). Additionally, we explored the relationship between trait resilience and the severity of drug-related problems. METHODS Four hundred and three participants (22 % female) with OUD completed the CD-RISC-25, Beck Depression Inventory (BDI-II), and the self-report Addiction Severity Index (ASI). Confirmatory factor analysis (CFA) tested the originally proposed 5-factor solution of the CD-RISC-25. RESULTS CFA results indicated that a 5-factor model of the CD-RISC-25 performed somewhat better than the 1-factor solution. Pearson correlation revealed a negative association between CD-RISC-25 (M = 75.82, SD = 15.78) and ASI drug-use composite score (M = .25, SD=-0.16), r=-0.148, p<.01, and between CD-RISC-25 and BDI-II (M = 11.33, SD = 10.58), r=-.237, p<.001. CONCLUSIONS Albeit providing only limited support for the original 5-factor structure, our results indicate that the scale may be useful for screening individuals with OUD who have a vulnerability to stress. Consistent with prior studies, higher resilience was associated with lower depression symptoms and addiction severity, further demonstrating the CD-RISC-25 ability to predict psychiatric stability. To inform the development of more targeted interventions, future studies should examine resilience longitudinally, in addition to exploring more comprehensive approaches to measuring resilience.
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Affiliation(s)
- Suky Martinez
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Jermaine D. Jones
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Laura Brandt
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Denise Hien
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA,Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Smithers Hall, 607 Allison Road, Piscataway NJ 08854 USA
| | - Aimee N.C. Campbell
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Sarai Batchelder
- Private Practice, 200 W 57th street, suite 1400 New York, NY 10019
| | - Sandra D. Comer
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
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5
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Yang X, Kovarik C, Wang Y, Yu S. A Multi-Site Cross-Sectional Study of Anxiety Symptoms and the Associated Factors Among Chinese Drug Users Undergoing Compulsory Detoxification Treatment. Front Public Health 2021; 9:524068. [PMID: 33777872 PMCID: PMC7990875 DOI: 10.3389/fpubh.2021.524068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/18/2021] [Indexed: 12/29/2022] Open
Abstract
Compulsory drug detoxification treatment (CDT) is currently the major drug rehabilitation modality in China, and drug users often suffer from extraordinary levels of stress during CDT, leading to a high prevalence of anxiety symptoms. This study assesses anxiety symptoms of the drug users undergoing CDT and explores the associated factors. A cross-sectional study with cluster sampling was conducted in three cities in Liaoning Province of Northeast China. Nine hundred CDT drug users were interviewed face-to-face with Chinese questionnaires. Hierarchical multiple regression (HMR) analysis was conducted to explore the factors associated with anxiety symptoms. The prevalence of anxiety symptoms among the CDT drug users was substantially high (33.2%). HMR analysis indicated perceived stress and characteristics of drug use such as types of drugs, were the most important contributors to anxiety symptoms. Optimism (LOT-R) played a protective role in reducing anxiety symptoms in this population. Anxiety symptoms of drug users undergoing CDT were present in a significant proportion of the CDT population. Optimism is a protective factor which could attenuate the detrimental effects of perceived stress on anxiety symptoms and potentially improve treatment outcomes.
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Affiliation(s)
- Xiaoshi Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, China
| | - Carrie Kovarik
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, United States
| | - Yuke Wang
- Liaoning Juvenile's Compulsory Drug Detention Center, Shenyang, China
| | - Shenshui Yu
- Liaoning Juvenile's Compulsory Drug Detention Center, Shenyang, China
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6
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Cao P, Zhang Z, Zhong J, Xu S, Huang Q, Fan N. Effects of treatment status and life quality on anxiety in MMT patients. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:9. [PMID: 33441176 PMCID: PMC7805232 DOI: 10.1186/s13011-021-00343-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 11/17/2022]
Abstract
Background Anxiety, an important factor that affects the therapeutic effect and preservation rate of methadone maintenance treatment, has a high prevalence among MMT patients. This study aims to investigate the effects of treatment status and life quality on anxiety in MMT patients. Methods One hundred and Seventy-seven methadone maintenance treatment users in Guangzhou, China were evaluated. The socio-demographic, duration and MMT-related characteristics were documented. Anxiety level and quality of life were evaluated by Beck Anxiety inventory (BAI) and the Quality of Life-Drug Addiction (QOL-DA) respectively. The correlation between different factors and BAI score was also analyzed. Results The BAI total score and the QOL-DA score were 7.1±8.2, 163.5±21.4 respectively. 30.5% of the subjects showed mild to severe anxiety. Treatment interruption and QOL-DA score had strong correlations with the score of BAI, with correlation coefficients of 0.17 and − 0.08 respectively. Conclusions Anxiety symptoms were commonly presented in MMT patients. Treatment interruption and quality of life are two major factors affecting anxiety of MMT patients.
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Affiliation(s)
- Penghui Cao
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong Province, China
| | - Zhaohua Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong Province, China
| | - Jun Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong Province, China
| | - Shichao Xu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong Province, China
| | - Qiaofang Huang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong Province, China
| | - Ni Fan
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong Province, China.
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Le TA, Le MQT, Dang AD, Dang AK, Nguyen CT, Pham HQ, Vu GT, Hoang CL, Tran TT, Vuong QH, Tran TH, Tran BX, Latkin CA, Ho CSH, Ho RCM. Multi-level predictors of psychological problems among methadone maintenance treatment patients in difference types of settings in Vietnam. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:39. [PMID: 31533764 PMCID: PMC6751619 DOI: 10.1186/s13011-019-0223-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/20/2019] [Indexed: 01/17/2023]
Abstract
Background Methadone, a long-acting opioid agonist maintenance treatment (MMT) is used to treat opioid addiction by preventing opioid withdrawal and reducing cravings. However, it is important to note that mental conditions may persist, or even remain undetected while methadone maintenance treatment is ongoing. This study aimed to examine the level of psychological problems among MMT patients at public and private health facilities and identify associated factors. Method From January to September 2018, a cross-sectional study was performed in Nam Dinh province, one of the largest epicenters providing HIV/AIDS surveillance and treatment services in the North of Vietnam. 395 male respondents currently receiving MMT agreed to participate in a face-to-face interview. Depression, Anxiety and Stress Scale-21 (DASS-21) were used to assess psychological problems among patients. Results The percentage of patients suffering from mild to extremely severe anxiety was the highest among psychological problems (18%). 2.8% of participants had mild depressive symptoms and the percentage of those having mild or moderate stress was approximately 4%. In addition, the longer treatment duration, the lower mental health scores regarding three types of psychological problems. Respondents who received MMT services in public health facilities were more likely to have a higher score of all psychological problems. Participants who lived with partners or spouse, having higher monthly family income had a lower likelihood of having severe depression and stress status. Freelancers or blue-collars/farmers had lower score of depression and anxiety compared to people being unemployed. Conclusion This study suggests that among our sample, MMT patients receiving treatment in public health facilities might have higher rate of psychological problems, including depression, anxiety, and stress than that of those in the private health facility. These results highlight the necessity of taking psychological counseling adequately for MMT patients and psychological assessment should be prioritized in the early stage of treatment.
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Affiliation(s)
- Tuan Anh Le
- National Institute of Hygiene and Epidemiology, Hanoi, 100000, Vietnam.,Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Mai Quynh Thi Le
- National Institute of Hygiene and Epidemiology, Hanoi, 100000, Vietnam
| | - Anh Duc Dang
- National Institute of Hygiene and Epidemiology, Hanoi, 100000, Vietnam
| | - Anh Kim Dang
- Institute for Global Health Innovations, Duy Tan University, Postal address: No. 73 Hoang Cau street, Hanoi, Da Nang, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Postal address: No. 73 Hoang Cau street, Hanoi, Da Nang, Vietnam.
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Postal address: No. 73 Hoang Cau street, Hanoi, Da Nang, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 700000, Vietnam
| | - Chi Linh Hoang
- Center of Excellence in Behavior Medicine, Nguyen Tat Thanh University, Ho Chi Minh, 700000, Vietnam
| | - Tung Thanh Tran
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 700000, Vietnam
| | - Quan-Hoang Vuong
- Centre for Interdisciplinary Social Research, Phenikaa University, Yen Nghia, Ha Dong, Hanoi, 100803, Vietnam.,Faculty of Economics and Finance, Phenikaa University, Yen Nghia, Ha Dong, Hanoi, 100803, Vietnam
| | - Tung Hoang Tran
- Institute of Orthopaedic and Trauma Surgery, Vietnam - Germany Hospital, Hanoi, 100000, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, 119074, Singapore
| | - Roger C M Ho
- Center of Excellence in Behavior Medicine, Nguyen Tat Thanh University, Ho Chi Minh, 700000, Vietnam.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599, Singapore.,Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore, 117599, Singapore
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8
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Wang L, Xu B, Gu Y, Zhu J, Liang Y. The mediating and moderating effects of resilience on the relationship between perceived stress and depression in heroin addicts. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:495-503. [PMID: 30345512 DOI: 10.1002/jcop.22133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/26/2018] [Accepted: 08/26/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to examine the mediating and moderating roles of resilience on the relationship between perceived stress and depression among heroin addicts. A total of 138 heroin addicts completed the measures of perceived stress, resilience, and depression. Correlation analysis indicated that perceived stress was positively associated with depression. Resilience was negatively correlated with perceived stress and depression. Mediation analysis revealed that resilience partially mediated the relationship between perceived stress and depression. However, resilience did not moderate the influence of perceived stress on depression. These findings might provide a better understanding of the mental health among heroin addicts.
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Affiliation(s)
| | - Banghua Xu
- NanJing Normal University
- Shenzhen Polytechnic
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Li L, Wu Z, Liang LJ, Lin C, Luo S, Cao X, Hsieh J, Rou K. An intervention trial targeting methadone maintenance treatment providers to improve clients' treatment retention in China. Drug Alcohol Depend 2019; 194:143-150. [PMID: 30445272 PMCID: PMC6413495 DOI: 10.1016/j.drugalcdep.2018.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Service providers including doctors, nurses, and other healthcare professionals play an essential role in methadone maintenance treatment (MMT). This study evaluated the impact of an intervention targeting MMT providers on their clients' treatment retention. METHODS This study was conducted in 68 MMT clinics in five provinces of China with 36 clients randomly selected from each clinic. The clinics were randomized to intervention or control condition. The MMT CARE intervention started with group sessions to enhance providers' communication skills. The trained providers were encouraged to conduct individual sessions with clients to promote treatment engagement. The outcomes, which include client retention (main outcome) and their reception of provider-delivered individual sessions (process outcome), were measured over a 24-month period. RESULTS Significantly fewer intervention clients dropped out from MMT than control clients during the study period (31% vs. 41%; p < 0.0001). Dropout hazard was significantly lower in the intervention condition compared to the control condition (HR = 0.71, 95% CI: 0.57, 0.89). More intervention clients had individual sessions than control clients (93% vs. 70%; p < 0.0001). Having individual sessions was associated with a significantly lower dropout hazard (HR = 0.30, 95% CI: 0.23, 0.40). The intervention clients had a significantly lower dropout hazard than the control clients if they started the individual sessions during the first six months (HR = 0.68, 95% CI: 0.51, 0.90). CONCLUSIONS The MMT CARE intervention focusing on provider capacity building has demonstrated efficacy in reducing clients' treatment dropout. This study sheds light on MMT service improvement in China and other global community-based harm reduction programs.
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Affiliation(s)
- Li Li
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Beijing, China
| | - Li-Jung Liang
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Sitong Luo
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Xiaobin Cao
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Beijing, China
| | - Julie Hsieh
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Keming Rou
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Beijing, China
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