The effect of cognitive-behavioral group therapy using trans-theoretical model on the level of depressive symptoms and methadone dose consumed by patients undergoing methadone maintenance treatment

Document Type : Research Paper

Authors

1 Assistant professor of psychology, Psychiatry and Behavioral Research Center, Mashhad University of Medical Sciences

2 Ph.D. in psychology, Mashhad University of Medical Sciences

3 M.Sc. in psychology, Mashhad University of Medical Sciences

Abstract

Introduction: This study aims to investigate the effect of cognitive-behavioral group therapy using trans-theoretical model on the level of depressive symptoms and methadone dose consumed by patients undergoing methadone maintenance treatment (MMT).
 Materials and Methods: This clinical trial was conducted on MMT patients of Ibn Sina Hospital Clinic in Mashhad during 6 months (autumn and winter of 2010). Through available sampling, 12 patients were selected and underwent 15 sessions of cognitive-behavioral group psychotherapy using trans-theoretical model, and 12 patients also formed the control group. Inclusion criteria were literacy (ability to read and write), passing at least a month after the end of MMT induction period, lack of major psychiatric disorders on axis I except for opiate dependency, and lack of borderline personality disorder. The methadone dose was obtained from daily clinic medical reports and depression symptoms were measured by symptom checklist-90-revised test at the beginning and end of the study. Data analysis was performed by SPSS version 16, using independent t-test and one-way ANOVA.
 Results: There was a significant difference (P<0.001) as much as 57% between the subjects’ mean depression scores in the two test and control groups after controlling the effect of pre-test, age, and methadone consumption. However, there was no significant difference between the mean methadone dose consumed among the two groups in post-test (P=0.07).
 Conclusion: Cognitive-behavioral group therapy using trans-theoretical model could be effective in reducing depression symptoms in patients undergoing methadone maintenance treatment; however, it has no significant effect on methadone dose consumed by them in the short term.

Keywords

References

1. Salehi B, Solhi H, Fotovat AR, Motamedi D, Moradi S, Ebrahimi S. [The comparison of the psychiatric disorders between opium addicts' families referring to opium withdrawal clinics and non-addicts' families referring to blood transmission centers]. Arak Medical University journal 2012; 15(3): 32-8. (Persian)
2. Madadi AA. [Addiction and substance abuse]. 1st ed. Tehran: Jameanegar; 2005: 56-7. (Persian)
3. Saryazdi H. [Diagnosis in addiction treatment]. 2nd ed. Isfahan, Farhang-e-Mardom; 2002: 91-8. (Persian)
4. Khademi A. [Counseling with addicts]. 1st ed. Tehran: Roshd; 2006: 281-302. (Persian)
5. Tabatabaei Chehr M, Ebrahimi Sani E, Mortazavi H. [The effectiveness of group cognitive - behavioral psychotherapy on changing of irrational beliefs in male addicts]. Journal of North Khorasan University of Medical Sciences 2012; 4(3): 419-32. (Persian)
6. Karimian N. [The Effectiveness of cognitive-behavioral stress management on relapse prevention in substance dependent men]. Addiction research 2012; 5(20): 73-86. (Persian)
7. Azad H. [Psychopathology]. 5th ed. Tehran: Beast; 2005: 221-68. (Persian)
8. Sanaei B. [Psychotherapy and group counseling]. 3rd ed. Tehran: Chehr; 2004: 64-103. (Persian)
9. Strain EC, Anthony JC. Substance related disorders. Introduction and overview. In: Sadock BJ, Sadock VA, Ruiz P. (editors). Kaplan and Sadocks’ comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2009: 1267.
10. Golparvar M, Khalatbari J. [Etiology and of addiction and substance abuse]. 1st ed. Tehran: Davavin; 2002: 109-19. (Persian)
11. Lyvers M, Yakimoff M. Neuro-psychological correlates of opioid dependence and withdrawal. Addict Behav 2003; 28: 605-11.
12. Mintzer MZ, Copersino ML, Stitzer ML. Opioid abuse and cognitive performance. Drug Alcohol Depend 2005; 78(2): 225-30.
13. Strain EC, Lofwall MR, Jaffe JH. Opioid-related disorders. Mood disorders: Historical introduction and conceptual overview. In: Sadock BJ, Sadock VA, Ruiz P. (editors). Kaplan and Sadocks’ comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2009: 1366, 1373, 1381.
14. Darke S, Sims J, McDonald S, Wickes W. Cognitive impairment among methadone maintenance patients. Addiction 2006; 95(5): 687-95.
15. Pirastu R, Fais R, Messina M, Bini V, Spiga S, Falconieri D, et al. Impaired decision-making in opiate-dependent subjects: Effect of pharmacological therapies. Drug Alcohol Depend 2006; 83(2): 163-8.
16. National Protocol MMT: 39-44. Available from: vc-trethment.kums.ac.ir/kums_content/media/image/.../25571_orig.pdf
17. Ziauddini H, Hosseini M, Nocani M, Tofani K. Group treatment for substance abuse. 1st ed. Tehran: Arjmand; 2005: 14-18.
18. Derogatis LR. Symptom checklist-90-R. Administrative scoring and procedures manual. Minneapolis: NCS Pearson; 1994: 167-8.
19. Nojomi M, Gharayee B. Medical students and mental health by SCL-90-R. Med J Islam Repub Iran 2007; 21(2): 71-8.
20. Momeni F, Moshtagh N, Purshahbaz A. Effectiveness of cognitive-behavioral group therapy on craving, depression and anxiety among the opiate abusers under MMT. Iranian rehabilitation journal 2010; 8(11): 19-23.
21. Akiskal HS. Mood disorders: Historical introduction and conceptual overview. In: Sadock BJ, Sadock VA, Ruiz P. (editors). Kaplan and Sadocks’ comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2009: 1637.
22. Abela JR, Skitch SA. Dysfunctional attitudes, self-esteem, and hassles: Cognitive vulnerability to depression in children of affectively ill parents. Behav Res Ther 2007; 45(6): 1127-40.
23. Seraj Khorrami N, Seif AA. [Comparison of the efficacy of behavioral therapy, cognitive therapy and group therapy in opioid dependency]. Knowledge and research in applied psychology 2003; 5(17): 21-40. (Persian)
24. Tanhaei HA, Valizadeh M. [A study of functional role of addiction rehabilitation group structure, A case study]. Iranian journal of sociology 2010; 5(1): 41-73. (Persian)
25. Sadock BJ, Sadock VA. Kaplan and Sadocks’ synopsis of psychiatry, behavioral sciences/clinical psychiatry. 10th ed. Philadelphia: Lippincott Williams and Wilkins; 2007: 798.
26. National Drug Strategy. Available from: URL; http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/FE16C454A782A8AFCA2575BE002044D0/$File/m7110.pdf.
Journal of Fundamentals of Mental Health
Volume 15, Issue 58 - Serial Number 58
Summer 2013
September and October 2013
Pages 91-99

Files

Share

How to cite

Statistics