Abstract
Methamphetamine abusers often complain of feelings of depression that can complicate accurately diagnosing these individuals during treatments for methamphetamine abuse. This article presents an examination of temporal associations between documented methamphetamine use and reported ratings of depression among 162 gay and bisexual male methamphetamine abusers who participated in a 16-week randomized clinical trial of four behavioral therapies for methamphetamine abuse. Methamphetamine use was measured using thrice-weekly urine samples analyzed for drug metabolite. Self-reported depressive symptoms were collected weekly using the Beck Depression Inventory (BDI). At treatment entry, 73.2% of participants rated their depressive symptoms as mild or higher in severity (BDI≥10), with 28.5% reporting BDI scores in the moderate to severe range (BDI≥19). All participants reported significant decreases in depressive symptoms from baseline through the end of treatment, regardless of treatment condition, HIV status, or mood disorder diagnosis. A mixed regression model showed methamphetamine use for up to 5 days prior to the BDI score strongly predicted depressive symptoms (F1,968=18.6, P<.0001), while BDI scores had no significant association with subsequent methamphetamine use. Findings show that behavioral methamphetamine abuse treatment yields reductions in methamphetamine use and concomitant depressive symptom ratings that are sustained to 1 year after treatment entry.
Keywords: Depression, methamphetamine, drug abuse treatment, gay men
Full Text
The Full Text of this article is available as a PDF (137.9 KB).
References
- 1.Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Washington, DC: American Psychiatric Association; 2000.
- 2.Markou A, Kenny PJ. Neuroadaptations to chronic exposure to drugs of abuse: relevance to depressive symptomatology seen across psychiatric diagnostic categories. Neurotoxicol Res. 2002;4:297–313. doi: 10.1080/10298420290023963. [DOI] [PubMed] [Google Scholar]
- 3.Rawson RA, Gonzales R, Brethen P. Treatment of methamphetamine use disorders: an update. J Subst Abuse Treat. 2002;23:145–150. doi: 10.1016/S0740-5472(02)00256-8. [DOI] [PubMed] [Google Scholar]
- 4.Kalechstein AD, Newton TF, Longshore D, Anglin MD, Gorp WG, Gawin FH. Psychiatric comorbidity of methamphetamine dependence in a forensic sample. J Neuropsychiatry Clin Neurosci Fall. 2000;12:480–484. doi: 10.1176/jnp.12.4.480. [DOI] [PubMed] [Google Scholar]
- 5.Huber A, Shoptaw S, Roll JM, Rawson RA, Ling W. Randomized trial of sertraline and contingency management for methamphetamine dependence. Paper presented at: American Psychological Association. Annual Convention; August 22–25, 2002; Chicago, IL.
- 6.Golloway GP, Newmeyer J, Knapp T, Stalcup SA, Smith D. A controlled trial of imipramine for the treatment of methamphetamine dependence. J Subst Abuse Treat. 1996;13:493–497. doi: 10.1016/S0740-5472(96)00154-7. [DOI] [PubMed] [Google Scholar]
- 7.Rawson RA, Huber A, Brethen P, et al. Status of methamphetamine users 2–5 years after outpatient treatment. J Addict Dis. 2002;21:107–119. doi: 10.1300/J069v21n01_09. [DOI] [PubMed] [Google Scholar]
- 8.Stall R, Paul JP, Greenwood G, et al. Alconol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men’s Health Study. Addiction. 2001;96:1589–1601. doi: 10.1046/j.1360-0443.2001.961115896.x. [DOI] [PubMed] [Google Scholar]
- 9.Cochran SD, Mays VM, Sullivan JG. Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. J Consult Clin Psychol. 2003;71:53–61. doi: 10.1037//0022-006x.71.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Deren S, Beardsley M, Coyle S, Singer M. HIV serostatus and risk behaviors in a multisite sample of drug users. J Psychoactive Drugs. 1998;30:239–245. doi: 10.1080/02791072.1998.10399698. [DOI] [PubMed] [Google Scholar]
- 11.Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. West J Med. 1998;168:93–97. [PMC free article] [PubMed] [Google Scholar]
- 12.Spitzer RL, William JB, Gibbon M, First MB. The Structured Clinical Interview for the DSM-IV (SCID) Washington, DC: American Psychiatric Press; 1995. [Google Scholar]
- 13.Shoptaw S, Reback CJ, Peck JA, et al. Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. In press, Drug and Alcohol Dependence. [DOI] [PubMed]
- 14.Stout RL, Wirtz PW, Carbonari JP, Boca FK. Ensuring balanced distribution of prognostic factors in treatment outcome research. J Stud Alcohol. 1994;12:70–75. doi: 10.15288/jsas.1994.s12.70. [DOI] [PubMed] [Google Scholar]
- 15.Beck AT. Depression. Philadelphia, PA: University of Pennsylvania Press; 1967. [Google Scholar]
- 16.McLellan AT, Kushner H, Metzger D. The fifth edition of the Addiction Severity Index. J Subst Abuse Treat. 1992;9:199–213. doi: 10.1016/0740-5472(92)90062-S. [DOI] [PubMed] [Google Scholar]
- 17.Rawson RA, Shoptaw S, Obert JL, et al. An intensive outpatient approach for cocaine abuse treatment: the matrix model. J Subst Abuse Treat. 1995;12:117–127. doi: 10.1016/0740-5472(94)00080-B. [DOI] [PubMed] [Google Scholar]
- 18.Higgins ST, Budney AJ, Bickel WK, Hughes JR, Foerg F, Badjer G. Achieving cocaine abstinence with a behavioral approach. Am J Psychiatry. 1993;150:763–769. doi: 10.1176/ajp.150.5.763. [DOI] [PubMed] [Google Scholar]
- 19.Shoptaw S, Peck J, Reback CJ, Rotheram-Fuller E. Psychiatric and substance dependence comorbidities, sexually transmitted diseases, and risk behaviors among methamphetaminedependent gay and bisexual men seeking outpatient drug abuse treatment. J Psychoactive Drugs. 2003;35:161–168. doi: 10.1080/02791072.2003.10400511. [DOI] [PubMed] [Google Scholar]