Abstract
BackgroundAddiction 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.MethodsUsing 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.ResultsA 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.ConclusionsThis 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.
Highlights
Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role
Even if the existing literature has explored the correlations between substance use and different areas of psychopathology, and put forward hypotheses about the mechanisms that trigger substance use and/or psychopathology, it has left unexplored an extensive grey area pertinent to the question of whether some
Of the symptoms usually exhibited by addicted people, especially in the domains of mood, anxiety and impulse control, belong to addiction or to comorbid psychiatric disorders [11]
Summary
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 possess specific psychopathological dimensions. Of the symptoms usually exhibited by addicted people, especially in the domains of mood, anxiety and impulse control, belong to addiction or to comorbid psychiatric disorders [11]. This is a central question since, before asking what comes first (addiction or another psychiatric condition), the problem of the real independence of symptoms, or of close linkage between the psychiatric symptoms and the central symptoms of addiction that appear together with it needs to be solved
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