Motivation for treatment in patients with substance use disorder: personal volunteering versus legal/familial enforcement

Abstract

Rabia Bilici,1 Esra Yazici,2 Ali Evren Tufan,3 Elif Mutlu,4 Filiz İzci,1 Görkem Karakas Ugurlu5 1Erenkoy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul; 2Sakarya University, Medical Faculty, Department of Psychiatry, Sakarya, 3Abant Izzet Baysal University, Medical Faculty, Department of Child and Adolescent Psychiatry, Bolu, 4Bakirköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, 5Yildirim Beyazit University, Medical Faculty, Department of Psychiatry, Ankara, Turkey Background: Motivation for treatment on the part of patients with addictive disorders is known to affect their prognosis, and lack thereof is reported to be among the most common reasons for failed treatment adherence and relapse after treatment. This study evaluated the relationship between volunteering, personality, demographic factors, and motivation for treatment. Methods: The study was conducted at a substance dependence center in the eastern part of Turkey. Forty-five patients (mean age 37.9±11.2 years) with a substance use disorder were included. They were assessed using the Structured Clinical Interview for DSM (Diagnostic and Statistical Manual of Mental Disorders) Axis II disorders. Depression and anxiety were evaluated using the Beck depression and anxiety inventories, and motivation for treatment was measured using the Turkish version of the Texas Christian University Motivation for Treatment scale. Results: All patients had been using substances daily and 41 (88.9%) had been using multiple drugs. The most commonly used substance was heroin (n=18, 40%). Voluntary admission was a predictor of motivation for treatment (P<0.05). Having a personality disorder and higher depression scores were related to less motivation for treatment. Conclusion: Motivation for treatment is affected by external factors such as type of admission and internal factors such as personality disorder and depression. Investigation of ways to encourage voluntary admission for treatment instead of enforced strategies may be helpful for achieving higher levels of motivation for treatment in substance users. Keywords: substance use, motivation, treatment, voluntary, personality, depression