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Relations Among Psychopathology, Substance Use, and Physical Pain Experiences in Methadone-Maintained Patients

J Clin Psychiatry 2009;70(9):1213-1218
10.4088/JCP.08m04367

Objective: Differences in psychiatric distress and substance use (licit and illicit) were examined in methadone maintenance treatment (MMT) patients with a variety of pain experiences.

Method: Parametric and nonparametric statistical tests were performed on data obtained from 150 patients currently enrolled in MMT. Assessments were carried out at the 3 opioid agonist treatment programs operated by the APT Foundation, New Haven, Connecticut. Participants were recruited between March 2007 and March 2008.

Results: In comparison to MMT patients reporting no pain in the previous week, those with chronic severe pain (CSP) (ie, pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) exhibited significantly higher (P < .01) levels of depression, anxiety, somatization, overall psychiatric distress, and personality disorder criteria but reported comparable rates of substance use. A third group, ie, non-CSP MMT patients reporting some pain in the past week, differed significantly (P < .05) from the other 2 pain groups on somatization and global psychiatric distress but reported comparable rates of substance use.

Conclusions: Pain-related differences in psychiatric problems exist in MMT patients and may have implications for program planning and outreach efforts.


Submitted: May 9, 2008; accepted October 31, 2008.

Online ahead of print: July 14, 2009.

Corresponding author: Declan T. Barry, PhD, Yale University School of Medicine, CMHC/SAC Room 220, 34 Park St, New Haven, CT 06519-1187 (declan.barry@yale.edu).