Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neuropsychiatry

To evaluate the clinical characteristics of patients with current tramadol dependence disorder compared to heroin dependence disorder, examine association between sociodemographic variables and dependence disorder of each substance, identify the risk factors correlated to dependence disorder of each substance and correlate the quality of life to severity of dependence of each substance in addition to other characteristics. A cross sectional observational study including 100 treatment seeking patients with either tramadol or heroin as a primary substance of dependence. Recruited from patients attending Kasr Alainy hospital addiction department (inpatient and outpatient) and Maadi private hospitals for treatment of addiction psychometric assessment included: Psychiatric assessment using MINI, addiction severity index (ASI), assessment of quality of life using WHO QoL BREF, motives of initial and continued substance use and history of traumatic life events. Tramadol patients had lower educational level, more manual work, initiated any substance at older age, less previous treatment trials (including inpatient admission), more seizures, less legal complications, better environmental QoL, more childhood trauma and less number of lifetime trauma. Kasr AlAiny received less education, had manual work, started cigarette smoking and the use of any substance at younger age. The inpatient groups had worse medical condition, longer addiction treatment history, seizures, more deterioration in occupational, drug and psychiatric domains of ASI, more co- morbid mood disorders, ADHD and substance induced psychiatric disorders and were exposed to multiple lifetime trauma. In the regression models, heroin use predicted worse environmental and social quality of life. Being KA inpatient predicted more lifetime trauma and childhood trauma. Both heroin and KA inpatient predicted worse medical condition. Heroin patients are worse in most of the aspects of medical, psychiatric, social and legal domains. Tramadol are more likely to suffer from seizures. There is a difference based on recruitment site, inpatient/outpatient

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