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Heroin Addiction and Related Clinical Problems: 2016, 18, N6 (pages: 43 - 50)

Psychopathological Dimensions and Addictive Behaviours in Heroin Use Disorder Patients

Maremmani A.G.I., Rovai L., Bacciardi S., Massimetti E., Gazzarrini D., Pallucchini A., Rugani F., Pani P.P., and Maremmani I.

Summary: Background. Specific psychopathology of Heroin Use Disorder (HUD) patients has been proved to be independent of treatment location (outpatient facilities or therapeutic communities), detoxification status, and patients' lifetime psychiatric issues. It was able to successfully discriminate between depressed patients and HUD patients. It also influenced treatment outcomes during methadone and buprenorphine treatment. When the 13 addictive behaviours of HUD patients were examined, Dual Disorder (DD) HUD patients showed a particular addictive behaviour pattern correlated with finding and taking opioids to alleviate psychopathology. In this study we tried to typify these addictive behaviours according to the severity of HUD-specific psychopathology, by checking the influence of the severity of psychopathological dimensions on the addictive behaviours we had previously found in DD-HUD patients. Methods. We examined, in this naturalistic, observational, cross-sectional study, the correlations between psychopathological dimensions and addictive behaviours in 114 HUD patients, at Agonist Opioid Treatment entry. We used the nonlinear canonical correlation analysis. Results. Significant correlations were found between severity of ‘worthlessness-being trapped' and ‘panic-anxiety' symptomatology, and the tendency of patients to adopt risk behaviours, using syringes that don't look good or injecting everything they think ‘will work' in absence of heroin, and prizing heroin much more than anything else they ever enjoyed before. The severity of sensitivity-psychoticism symptomatology correlated with having trouble using anti-withdrawal pills and with being willing to put up with a lot of stress to get heroin. Behaviours related to obsessive craving, relief craving or cue-induced behaviours showed lower correlation with the severity of psychopathology. Conclusions. Typifying addictive behaviours in HUD patients on the basis of the severity of their psychopathological dimensions is possible only for depressed-anxious or sensitive-psychotic patients, who are characterized by risk behaviours and with finding and taking opioids to alleviate psychopathology. The majority of addictive behaviours we investigated were not related to the severity of the psychopathology shown.