title: Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90).
abstract: BACKGROUND
  Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions.
  
  
  METHODS
  Using the Self-Report Symptom Inventory (SCL-90), we studied the psychopathological dimensions of 1,055 patients with heroin addiction (884 males and 171 females) aged between 16 and 59 years at the beginning of treatment, and their relationship to age, sex and duration of dependence.
  
  
  RESULTS
  A total of 150 (14.2%) patients with heroin addiction showed depressive symptomatology characterised by feelings of worthlessness and being trapped or caught; 257 (24.4%) had somatisation symptoms, 205 (19.4%) interpersonal sensitivity and psychotic symptoms, 235 (22.3%) panic symptomatology, 208 (19.7%) violence and self-aggression. These dimensions were not correlated with sex or duration of dependence. Younger patients with heroin addiction were characterised by higher scores for violence-suicide, sensitivity and panic anxiety symptomatology. Older patients with heroin addiction showed higher scores for somatisation and worthlessness-being trapped symptomatology.
  
  
  CONCLUSIONS
  This study supports the hypothesis that mood, anxiety and impulse-control dysregulation are the core of the clinical phenomenology of addiction and should be incorporated into its nosology.
authors.affiliation: 'Vincent P Dole' Dual Diagnosis Unit, 'Santa Chiara' University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy.|AU-CNS, 'From Science to Public Policy' Association, Pietrasanta, Lucca, Italy.|'G De Lisio', Institute of Behavioural Sciences, Pisa, Italy.
authors.forename: Icro
authors.initials: I
authors.lastname: Maremmani
authors.affiliation: Social-Health Direction, Health District 8 (ASL 8), Cagliari, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Pani
authors.affiliation: 'Vincent P Dole' Dual Diagnosis Unit, 'Santa Chiara' University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy.|'G De Lisio', Institute of Behavioural Sciences, Pisa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Pacini
authors.affiliation: Drug Addiction Unit, Bolzano, Italy.
authors.forename: Jacopo V
authors.initials: JV
authors.lastname: Bizzarri
authors.affiliation: Social-Health Direction, Health District 8 (ASL 8), Cagliari, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Trogu
authors.affiliation: 'Vincent P Dole' Dual Diagnosis Unit, 'Santa Chiara' University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy.|AU-CNS, 'From Science to Public Policy' Association, Pietrasanta, Lucca, Italy.|'G De Lisio', Institute of Behavioural Sciences, Pisa, Italy.
authors.forename: Angelo Gi
authors.initials: AG
authors.lastname: Maremmani
authors.affiliation: Global Challenges Section, Human Security Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Gerra
authors.affiliation: 'Vincent P Dole' Dual Diagnosis Unit, 'Santa Chiara' University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy.|'G De Lisio', Institute of Behavioural Sciences, Pisa, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Perugi
authors.affiliation: 'Vincent P Dole' Dual Diagnosis Unit, 'Santa Chiara' University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
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