Diagnosis and symptoms of depression in opiate addicts. Course and relationship to treatment outcome.

Evaluations of diagnosis and symptoms of depression were undertaken in 157 opiate addicts at entrance to a multimodality drug treatment program and six months later. While 17% were having an episode of major depression (defined by Research Diagnostic Criteria) and 60% had at least mildly elevated depressive symptoms at entrance to treatment, substantial improvement was noted at the six-month reevaluation, with the rates of major depression and elevated symptoms dropping to 12% and 31%, respectively. Symptomatic improvement, although related to retention in treatment, was not the result of specific antidepressant pharmacotherapy and did not differ across treatment modalities. Starting treatment during a major or minor depressive episode was predictive of poorer outcome in the areas of illicit drug use and psychological symptoms, but unrelated to the areas of occupational functioning, legal problems, and program retention.