Les schémas précoces inadaptés et la rechute au cours de traitement de maintien par la méthadone chez les toxicomanes (une approche cognitive)

Abstract

Introduction/objectiveDysfunction of cognitive schemas and addictive behaviors are often coexisting which can cause relapse during drug treatment. The objective of this study is to assess early maladaptive schemas (EMS) among heroin users and their relationship with relapse during methadone maintenance treatment. Subject and methodsThis is a cross-sectional study carried out on 166 heroin users treated with methadone at the medico-psychological center in northern Morocco during 2017. The subjects completed both the Young short version schema questionnaire (YQS) and the ASI questionnaire (Addiction Severity Index) to measure the severity of drug addiction. ResultsThe results showed that the most activated schemas in the totality of the subjects were fear of losing control, Emotional deficiency and failure. They were also significantly more activated in women than in men for five schemas indicating rejection and separation, and a lack of autonomy. Regarding the relapse during treatment consumption there was a positive and significant correlation with ten out of thirteen SPI, which means the more the intensity of SPI decrease the greater the tendency to relapse (r=0.509, P<0.0001). However, there was also a weak correlation between the consumption of other drugs and SPI. ConclusionThe cognitive approach has highlighted the essential role of cognitive disorders in addictive behaviors that EMS may be predictors of relapse during substitution treatment, and that a concurrent therapy of schema may reduce the likelihood of relapse.