Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90).
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.
Maremmani
Icro
I
'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.
Pani
Pier Paolo
PP
Social-Health Direction, Health District 8 (ASL 8), Cagliari, Italy.
Pacini
Matteo
M
'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.
Bizzarri
Jacopo V
JV
Drug Addiction Unit, Bolzano, Italy.
Trogu
Emanuela
E
Social-Health Direction, Health District 8 (ASL 8), Cagliari, Italy.
Maremmani
Angelo Gi
AG
'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.
Gerra
Gilberto
G
Global Challenges Section, Human Security Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna.
Perugi
Giulio
G
'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.
Dell'Osso
Liliana
L
'Vincent P Dole' Dual Diagnosis Unit, 'Santa Chiara' University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy.
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