title: Psychopathological symptoms of patients with heroin addiction entering opioid agonist or therapeutic community treatment.
abstract: BACKGROUND
  The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychopathological profiles of patients entering a TC versus an OAT treatment and at the correlation between gender and the observed psychopathology.
  
  
  METHODS
  A confirmatory factor analysis was performed on the results of SCL-90 filled by 1,195 patients with heroin dependence entering TC treatment. It replicates the extraction method previously used on 1,055 OAT patients with heroin addiction by using a principal component factor analysis (PCA). The association between the kind of treatment received (TC or OAT), gender, and the psychopathological dimensions was assessed through logistic regression and general linear model (GLM) analysis.
  
  
  RESULTS
  The PCA carried out on the SCL-90 results of patients entering a TC yielded a five-factor solution, confirming the same dimensions observed in patients entering an OAT: 'worthlessness and being trapped', 'somatization', 'sensitivity-psychoticism', 'panic anxiety', and 'violence-suicide'. The logistic regression analysis showed a statistically significant association between 'somatization' and 'violence-suicide' severity score and OAT. GLM analysis showed that psychopathological factorial scores for 'worthlessness-being trapped', 'somatic symptoms', and 'panic anxiety' dimensions were more severe in OAT vs TC male patients and in TC vs OAT female ones. 'Violence suicide' followed the same severity pattern for males, but did not differ in TC vs OAT females, while 'sensitivity-psychoticism' did not differ in OAT vs TC patients. The five dimensions did not differ in OAT males vs females.
  
  
  CONCLUSIONS
  Our research appears to confirm the existence of a specific aggregation of psychological/psychiatric features within the category of individuals with heroin addiction. It also shows a correlation between the dominant psychopathological subgroup and the assignment to TC versus OAT. Further research is needed to clarify the differences between the five psychopathological subgroups and their determinants.
authors.affiliation: Social and Health Services, Cagliari Health Public Trust (ASL Cagliari), Cagliari, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Pani
authors.affiliation: Department of Psychiatry, Cagliari Health Public Trust (ASL Cagliari), Cagliari, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Trogu
authors.affiliation: Piedmont Centre for Drug Addiction Epidemiology, ASLTO3 Grugliasco, Turin, Italy ; Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Vigna-Taglianti
authors.affiliation: Piedmont Centre for Drug Addiction Epidemiology, ASLTO3 Grugliasco, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Mathis
authors.affiliation: Piedmont Centre for Drug Addiction Epidemiology, ASLTO3 Grugliasco, Turin, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Diecidue
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kirchmayer
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Amato
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Davoli
authors.affiliation: National Coordination Hospitality Communities (CNCA), Rome, Italy.
authors.forename: Joli
authors.initials: J
authors.lastname: Ghibaudi
authors.affiliation: National Coordination Hospitality Communities (CNCA), Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Camposeragna
authors.affiliation: Regional Epidemiologic Observatory, Emilia Romagna Regional Health Service, Bologna, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Saponaro
authors.affiliation: Department of Translational Medicine, Avogadro University, Novara, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Faggiano
authors.affiliation: Department of Neurosciences, Vincent P. Dole Dual Diagnosis Unit, Santa Chiara University Hospital, University of Pisa, Pisa, Italy ; Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy.
authors.forename: Angelo Giovanni Icro
authors.initials: AG
authors.lastname: Maremmani
authors.affiliation: Department of Neurosciences, Vincent P. Dole Dual Diagnosis Unit, Santa Chiara University Hospital, University of Pisa, Pisa, Italy ; Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy ; G. De Lisio Institute of Behavioural Sciences, Pisa, Italy.
authors.forename: Icro
authors.initials: I
authors.lastname: Maremmani
keywords: Gender differences; Opioid agonist treatment; Psychopathological symptoms; Residential treatment community; SCL-90