A cross-sectional study of treatment-seeking individuals with opioid dependence in India reveals significant comorbidity between depression and anxiety, with implications for disability and quality of life. The research, conducted at a tertiary care center in North India, assessed 255 adult patients diagnosed with opioid dependence using standardized instruments including the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety.
The study population consisted exclusively of male patients with a median age of 28 years. Heroin was the predominant opioid used by 87% of participants, and 30% reported injecting use. More than half (57%) had moderate-to-severe depression and 42% had moderate-to-severe anxiety, which were strongly correlated (r = 0.90). Both depression and anxiety were associated with higher disability and poorer quality of life across all measured domains.
Key findings and predictors
Depression was independently predicted by stigma (odds ratio = 2.95), interpersonal problems (odds ratio = 4.21), and the absence of opioid agonist treatment. The relationship between opioid substitution therapy and depression was moderated by stigma, with the protective effect of treatment being attenuated in individuals who reported stigma. For anxiety, interpersonal problems emerged as the strongest predictor (odds ratio = 4.98), while past-month abstinence was protective (odds ratio = 0.45). Employment status also showed significant associations with depression, anxiety, all quality of life domains, and disability.
The depression score on the PHQ-9 had a median of 11.00, while the anxiety score on the GAD-7 had a median of 8.00. The observed depression rates are higher than global pooled estimates of 36%, likely because the sample comprised treatment-seeking individuals experiencing greater psychosocial stressors. Both depression and anxiety were most strongly negatively correlated with physical quality of life, followed by environmental and psychological domains.
Clinical implications
The findings highlight the significant burden of depression and anxiety among individuals with opioid dependence, with critical implications for treatment planning. The study emphasizes that psychological distress, more than the severity of drug use itself, is the main factor driving poorer quality of life in this population. Future research should focus on stigma reduction, optimization of opioid agonist treatment, and integration of mental health care within addiction services.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1708666/full