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Heroin Addiction and Related Clinical Problems: 2012, 14, 1 (pages: 11 - 22)

Heroin addicts' psychopathological subtypes. Correlations with the natural history of illness

Maremmani A. G. I., Rovai L., Pani P. P., Maremmani I.

Summary: By recently using an exploratory factor analysis of the 90 items in the SCL-90, we identified a five-factor solution for 1055 heroin addicts who answered that questionnaire at treatment entry. On the basis of the highest z-scores obtained on these factors, subjects can be assigned to 5 mutually exclusive groups labelled “worthlessness and being trapped”, “somatization”, “sensitivity-psychoticism”, “panic anxiety”, and “violence-suicide”. In this study we correlated the distribution within these groups of 455 heroin addicts The patients belonging to the “worthlessness and being trapped” group had the highest average age and were those who, most frequently, had a white-collar job. Those belonging to the “somatization” group were less frequently at their first treatment, more frequently reported sleep disturbances and less frequently referred to their use of hallucinogens. The leading distinctive feature of those in the “sensitivity-psychoticism” group was that they were the youngest. Patients belonging to the “panic anxiety” group less frequently reported major problems with their love life, sleep disturbances, and more frequently referred to their use of CNS stimulants. The features of being more excitable and violent brought with them the highest likelihood of belonging to the “violence-suicide” group. These differences were independent of the presence of dual diagnosis. These data support the hypothesis that heroin has as its foundation a specific psychopathology.