The official journal of
EUROPAD - European Opiate Addiction Treatment Association
WFTOD - World Federation for the Treatment of Opioid Dependence
Editor: Icro Maremmani, MD - Pisa, Italy, EU
Associate Editors:
Thomas Clausen, MD - Oslo, Norway
Pier Paolo Pani, MD - Cagliari, Italy, EU
Marta Torrens, MD - Barcelona, Spain, EU
Statistical Editor:
Mario Miccoli, PhD - Pisa, Italy, EU

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Heroin Addiction and Related Clinical Problems: 2024, 26, 4

Is the SCL90-based five-dimensional structure able to differentiate Heroin Use Disorder patients with low and high benzodiazepine dependence symptomatology?

Angelo G. I. Maremmani, Filippo Della Rocca, Silvia Bacciardi, Mario Miccoli, and Icro Maremmani

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Summary: Background: In continuing the validation process (discriminant validity) of the five psychopathological dimensions we have considered specific to substance use disorders (SUD), we assessed, in Heroin Use Disorder (HUD) patients, the correlations between psychopathology and severity of their benzodiazepine (BDZ) co-dependence, as well as their ability to distinguish between patients with low and high BDZ symptomatology. Methods: 78 subjects, 54 males and 24 females with a mean age of 25.56±4.5, were recruited to participate in the study. To evaluate benzodiazepine severity co-dependence, we used the SASA by Zung ed Eddy. Symptoms of psychopathology were assessed using the SCL-90 (Symptomatological Checklist) according to the Maremmani et al. factor analysis. According to the SASA score, 45 subjects showed low symptoms (L/BDZ), whereas 33 were patients with high symptoms of BDZ dependence (H/BDZ). Results: The severity of BDZ dependence positively correlated with the severity of all psychopathological dimensions except panic anxiety. H/BDZ HUD patients were characterised by more severe symptomatology than L/BDZ ones, especially in the categories relating to Violence/Suicide (V/S) and Somatic Symptoms (SS). The differences observed in the Worthlessness/Being Trapped (W/BT) and Sensitivity/Psychoticism (S/P) dimensions were minor but still significant. H/BDZ and L/BDZ HUD patients showed a different typology of psychopathology. Above all, the V/S type was strongly more represented in the H/BDZ group. Conclusions: In HUD patients, the psychopathology specific to SUD is correlated with the severity of BDZ co-dependence symptomatology and can differentiate the two severity groups, therefore providing further evidence of its sensitivity.

Keywords: Heroin Dependence; Heroin Addiction; BDZ co-dependence; psychopathology specific to substance use disorder; validity; discriminant validity.


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