Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study

Psychiatry Res. 2016 Sep 30:243:174-81. doi: 10.1016/j.psychres.2016.06.024. Epub 2016 Jun 17.


Opioid-dependent patients show a high rate of psychiatric comorbidities. The prevalence and characteristics of patients with dual diagnosis have not been well established in Spanish opioid agonist treatment (OAT) programmes. Thus, 621 opioid-dependent patients enrolled in OAT programmes were assessed, using the EuropASI questionnaire, for psychiatric comorbidities, which were detected in 67% of patients (anxiety 53%, mood disorders 48%, sleep disorders 41%, substance-related disorders 36%). In addition, compared with patients without a dual diagnosis, patients with dual pathology were significantly older, used benzodiazepines and cannabis in significantly greater percentages, and showed significantly more frequent infectious and non-infectious comorbidities, worse overall working status, a lower proportion of drivers and higher levels of severity regarding medical, employment, alcohol, legal, family and psychological issues. Therefore, the data showed a very high prevalence of psychiatric comorbidity in opioid-dependent patients receiving OAT in Spain and several problems frequently associated with patients with dual diagnosis. Physicians treating opioid-dependent patients should be aware of these facts to correctly identify and manage patients with a dual diagnosis.

Keywords: Comorbidity; Dual diagnosis; EuropASI questionnaire; Methadone; Opioid agonist treatment; Opioid dependence; Psychiatric.

MeSH terms

  • Adult
  • Comorbidity
  • Diagnosis, Dual (Psychiatry) / psychology
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Methadone / therapeutic use
  • Middle Aged
  • Opiate Substitution Treatment
  • Opioid-Related Disorders / drug therapy
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / psychology
  • Prevalence
  • Spain / epidemiology
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Young Adult


  • Methadone