Journal de recherche et de thérapie en toxicomanie

Abstrait

Long Term Quality of Life Outcome Among Opiate Addicts After the Nucleus Accumbens Ablative Neurosurgery

Guodong Gao, Shunnan Ge, Li Gao, Nan Li, Jing Wang, Lei Chen and Xuelian Wang

The bilateral Nucleus Accumbens (NAc) ablative neurosurgery has been reported to be a possible treatment to prevent the relapse for the opiate addicts. However, the factors affecting long term quality of life (QoL) outcome of this therapy was not well studied. The cross-sectional study of QoL was conducted on opiate addicts randomly selected from the patients who had undergone the NAc ablative surgery, at their 6th postoperative year by using the WHOQOL-BFEF instrument. Opiate addicts who have received detoxification treatment in mandatory residential compulsory rehabilitation centers were randomly selected as comparison samples.The socio-demographic characteristics and the current abstinent status of the participants were obtained by the structured questionnaire, and the Symptom Checklist-90-Revised (SCL-90-R) was applied for assessing the psychological symptoms. Comparing with the opiate addicts who had undergone residential compulsory detoxification, the opiate addicts who had undergone the NAc ablative surgery showed significantly better QoL in all four domains by WHOQOL-BREF instrument. For the surgical individuals, the relapse outcome and the severe psychological symptoms were strongly associated with the worse QoL. Besides severity of psychological symptoms which strongly predict the worse scores in all domains, the multiple linear regression analysis showed: older age, unsatisfied employment status and injection behaviors associated with lower QoL for physical domain; unsatisfied employment and marital status, lower educational level and injection behaviors associated with lower QoL for psychological domain; unsatisfied employment and marital status associated with lower QoL for social domain; unsatisfied employment and marital status, and injection behaviors associated with lower QoL for environmental domains.The results revealed that the opiate addicts represented a better QoL after the NAc ablative neurosurgery, comparing to the ones who received residential compulsory treatment. The relapseoutcome and the psychological symptoms play a decisive role on the QoL of the patient long term after the NAc ablative neurosurgery.