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Heroin Addiction and Related Clinical Problems: 2022, 24, N5 (pages: 43 - 50)

Can the Psychopathology Specific to Substance Use Disorder Distinguish between Recreational Cocaine Use and Cocaine Addiction?

Della Rocca F., Maremmani A.G.I., Bacciardi S., Miccoli M., and Maremmani I.

Summary: Background: In continuing the validation process of the five psychopathological dimensions which we have considered specific to Substance Use Disorders (SUD), we tested the possible correlations between them and the severity of behavioural covariates of cocaine craving, as well as their ability to distinguish between recreational and problematic cocaine users. Methods: 63 subjects, 50 males and 13 females, mean age 38±12 were recruited to participate in the study. To evaluate behavioural correlates of cocaine craving we used the CPSI (Cocaine Problem Severity Index). Symptoms of psychopathology were assessed by using the SCL-90 (Symptomatological Check List) according to the Maremmani et al. factor analysis. According to the CPSI score, 19 subjects showed experimental/recreational (E/R) cocaine use, whereas 44 were patients with ‘cocaine dependence requiring assistance (CDRA). Results: Cocaine craving was positively correlated with the severity of Sensitivity/Psychoticism (S/P) and Violence/Suicide (V/S) dimensions. E/R cocaine users were characterized by elevated values-scores in the categories relating to Worthlessness/Being Trapped (W/BT) and Somatic Symptoms (SS), whereas Sensitivity/Psychoticism (S/P), and Violence/Suicide (V/S) dimensions were characteristics of CDRA subjects. Somatic symptoms (SS) typology was more highly represented in the E/R group whereas Violence/Suicide (V/S) was more frequently represented in the CDRA group. The severity and typology of psychopathology were able to be differentiated between the E/R and CDRA patient groups. Conclusions: The psychopathology specific to SUD is correlated with cocaine-craving behavioural covariates and is able to differentiate E/R from CDRA patients and can differentiate-discern between E/R and CDRA patient groups, therefore providing further evidence of its specificity.