title: Do methadone and buprenorphine have the same impact on psychopathological symptoms of heroin addicts?
abstract: BACKGROUND
  The idea that the impact of opioid agonist treatment is influenced by the psychopathological profile of heroin addicts has not yet been investigated, and is based on the concept of a specific therapeutic action displayed by opioid agents on psychopathological symptoms. In the present report we compared the effects of buprenorphine and methadone on the psychopathological symptoms of 213 patients (106 on buprenorphine and 107 on methadone) in a follow-up study lasting 12 months.
  
  
  METHODS
  Drug addiction history was collected by means of the Drug Addiction History Rating Scale (DAH-RS) and psychopathological features were collected by means of the Symptom Checklist-90 (SCL-90), using a special five-factor solution. Toxicological urinalyses were carried out for each patient during the treatment period.
  
  
  RESULTS
  No statistically significant differences were detected in psychopathological symptoms, including 'worthlessness-being trapped', 'somatization', and 'panic-anxiety'. Methadone proved to be more effective on patients characterized by 'sensitivity-psychoticism', whereas buprenorphine was more effective on patients displaying a 'violence-suicide' symptomatology.
  
  
  CONCLUSIONS
  Heroin-dependent patients with psychiatric comorbidities may benefit from opioid agonist treatment not only because it targets their addictive problem, but also, precisely due to this, because it is effective against their mental disorder too.
authors.affiliation: 'Vincent P, Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy. maremman@med.unipi.it.
authors.forename: Angelo Giovanni Icro
authors.initials: AG
authors.lastname: Maremmani
authors.forename: Luca
authors.initials: L
authors.lastname: Rovai
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Pani
authors.forename: Matteo
authors.initials: M
authors.lastname: Pacini
authors.forename: Francesco
authors.initials: F
authors.lastname: Lamanna
authors.forename: Fabio
authors.initials: F
authors.lastname: Rugani
authors.forename: Elisa
authors.initials: E
authors.lastname: Schiavi
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'osso
authors.forename: Icro
authors.initials: I
authors.lastname: Maremmani