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Trajectories of depression among patients in treatment for opioid use disorder: A growth mixture model secondary analysis of the XBOT trial.

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Title: Trajectories of depression among patients in treatment for opioid use disorder: A growth mixture model secondary analysis of the XBOT trial.
Authors: Vest, Noel (AUTHOR), Wenzel, Kevin (AUTHOR), Choo, Tse‐Hwei (AUTHOR), Pavlicova, Martina (AUTHOR), Rotrosen, John (AUTHOR), Nunes, Edward (AUTHOR), Lee, Joshua D. (AUTHOR), Fishman, Marc (AUTHOR)
Source: American Journal on Addictions. May2023, Vol. 32 Issue 3, p291-300. 10p. 4 Charts, 2 Graphs.
Subjects: Opioid abuse, Growth disorders, Hamilton Depression Inventory, Mental depression, Secondary analysis
Abstract: Background and Objectives: To inform clinical practice, we identified subgroups of adults based on levels of depression symptomatology over time during opioid use disorder (OUD) treatment. Methods: Participants were 474 adults in a 24‐week treatment trial for OUD. Depression symptoms were measured using the 17‐item Hamilton Depression Rating Scale (HAM‐D) at nine‐time points. This was a secondary analysis of the Clinical Trials Network Extended‐Release Naltrexone versus Buprenorphine for Opioid Treatment (XBOT) trial using a growth mixture model. Results: Three distinct depression trajectories were identified: Class 1 High Recurring—10% with high HAM‐D with initial partial reductions (of HAM‐D across time), Class 2 Persistently High—5% with persistently high HAM‐D, and Class 3 Low Declining—85% of the participants, with low HAM‐D with early sustained reductions. The majority (low declining) had levels of depression that improved in the first 4 weeks and then stabilized across the treatment period. In contrast, 15% (high recurring and persistently high) had high initial levels that were more variable across time. The persistently high class had higher rates of opioid relapse. Discussion and Conclusions: In this OUD sample, most depressive symptomatology was mild and improved after medication treatment for opioid use disorder (MOUD). Smaller subgroups had higher depressive symptoms that persisted or recurred after the initiation of MOUD. Depressive symptoms should be followed in patients initiating treatment for OUD, and when persistent, should prompt further evaluation and consideration of antidepressant treatment. Scientific Significance: This study is the first to identify three distinct depression trajectories among a large clinical sample of individuals in MOUD treatment. [ABSTRACT FROM AUTHOR]
Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Trajectories of depression among patients in treatment for opioid use disorder: A growth mixture model secondary analysis of the XBOT trial.
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+on+Addictions%22">American Journal on Addictions</searchLink>. May2023, Vol. 32 Issue 3, p291-300. 10p. 4 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Opioid+abuse%22">Opioid abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Growth+disorders%22">Growth disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Hamilton+Depression+Inventory%22">Hamilton Depression Inventory</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+analysis%22">Secondary analysis</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and Objectives: To inform clinical practice, we identified subgroups of adults based on levels of depression symptomatology over time during opioid use disorder (OUD) treatment. Methods: Participants were 474 adults in a 24‐week treatment trial for OUD. Depression symptoms were measured using the 17‐item Hamilton Depression Rating Scale (HAM‐D) at nine‐time points. This was a secondary analysis of the Clinical Trials Network Extended‐Release Naltrexone versus Buprenorphine for Opioid Treatment (XBOT) trial using a growth mixture model. Results: Three distinct depression trajectories were identified: Class 1 High Recurring—10% with high HAM‐D with initial partial reductions (of HAM‐D across time), Class 2 Persistently High—5% with persistently high HAM‐D, and Class 3 Low Declining—85% of the participants, with low HAM‐D with early sustained reductions. The majority (low declining) had levels of depression that improved in the first 4 weeks and then stabilized across the treatment period. In contrast, 15% (high recurring and persistently high) had high initial levels that were more variable across time. The persistently high class had higher rates of opioid relapse. Discussion and Conclusions: In this OUD sample, most depressive symptomatology was mild and improved after medication treatment for opioid use disorder (MOUD). Smaller subgroups had higher depressive symptoms that persisted or recurred after the initiation of MOUD. Depressive symptoms should be followed in patients initiating treatment for OUD, and when persistent, should prompt further evaluation and consideration of antidepressant treatment. Scientific Significance: This study is the first to identify three distinct depression trajectories among a large clinical sample of individuals in MOUD treatment. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ajad.13371
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        Text: English
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        Type: general
      – SubjectFull: Growth disorders
        Type: general
      – SubjectFull: Hamilton Depression Inventory
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      – TitleFull: Trajectories of depression among patients in treatment for opioid use disorder: A growth mixture model secondary analysis of the XBOT trial.
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              M: 05
              Text: May2023
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              Y: 2023
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