Two types of classification for male opioid dependence: identification of an opioid addict with depressive features.
OBJECTIVE
There are similarities between alcoholics and opioid addicts and an overlap between both diagnostic groups. We tested the hypothesis that the type I and II classification, well established in male alcoholism, could also be relevant in a population of male opioid addicts.


METHODS
A sample of 100 hospitalized adult opioid dependent men were studied with the help of an extended semi-structured clinical interview, considering four classification criteria sets devised by Cloninger et al. (1981, 1982), von Knorring et al. (1985, 1987), Buydens-Branchey et al. (1989) and Babor et al. (1992).


RESULTS
The two types of classification could be confirmed with all four criteria sets. In at least three of four analyses, 52 patients were allocated to the same larger cluster C1, and 25 patients to a smaller cluster C2. These two groups were compared with each other with the help of the stepwise discriminant analysis. Seven variables were identified which excellently discriminate between the groups: The C2 patient is younger, has a history of therapy because of depression and a history of severe suicide attempts, also abuses benzodiazepines and becomes violent while intoxicated. His father suffers from alcoholism and received treatment because of depression. The C1 patient lacks these characteristics.


CONCLUSIONS
The hypothesis was confirmed, showing that the two types of classification for male opioid addicts is feasible. A depressive type of male opioid dependent patient was identified. Early identification of patients of this type is clinically important.
Modestin
J
J
University of Zurich, Department of Psychiatry, Burghölzli Hospital, Lenggstrasse 31, 8029, Zurich, Switzerland. modestin@bli.unizh.ch
Matutat
B
B
Würmle
O
O
D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology; D001007:Anxiety / Q000150:complications / Q000523:psychology; D016000:Cluster Analysis; D003866:Depressive Disorder / Q000145:classification* / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D005190:Family; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000145:classification* / Q000523:psychology*; D010556:Personality Tests; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013406:Suicide, Attempted / Q000523:psychology