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成瘾特定精神病理学的进一步证据。与其他精神科精神病理维度(如肥胖)的区分。

Further Evidence of a Specific Psychopathology of Addiction. Differentiation from Other Psychiatric Psychopathological Dimensions (Such as Obesity).

作者信息

Maremmani Angelo G I, Cerniglia Luca, Cimino Silvia, Bacciardi Silvia, Rovai Luca, Pallucchini Alessandro, Spera Vincenza, Perugi Giulio, Maremmani Icro

机构信息

Department of Psychiatry, North-Western Tuscany Region Local Health Unit, Versilia Zone, 55049 Viareggio, Italy.

AU-CNS, Association for the Application of Neuroscientific Knowledge to Social Aims, Pietrasanta, 55045 Lucca, Italy.

出版信息

Int J Environ Res Public Health. 2017 Aug 21;14(8):943. doi: 10.3390/ijerph14080943.

Abstract

Introduction In this study, we used a symptomatology checklist (SCL-90) to substantiate the hypothesis that Substance Use Disorder (SUD) has its own five-dimensional psychopathology. The aim of the present study was to test whether this psychopathology can be differentiated from other psychiatric psychopathological dimensions (such as obesity). The severity and frequency of each of the five dimensions were investigated, at univariate and multivariate levels, by comparing 972 Heroin Use Disorder (HUD) patients (83.5% male, mean age 30.12 ± 6.6, range: 16-59) and 106 obese individuals (50.0% male, mean age 37.59 ± 7.6, range: 24-52). The correlations between the Body Mass Index (BMI) of obese individuals with these psychopathological dimensions were also studied. Obese individuals showed higher SCL-90 total scores, global severity index scores, number of items rated positively, and positive symptoms distress index scores than HUD patients. The severity of all psychopathological dimensions was significantly higher in obese individuals. Discriminant analysis showed that Panic-Anxiety and Violence-Suicide severity were more frequent in obese patients, sufficiently so to allow differentiation between HUD (lower severity) and obese individuals (greater severity). At the reclassification level, 70.8% of obese individuals in the sample were reclassified as HUD patients. Psychopathological subtypes characterized by Panic-Anxiety and Violence-Suicide typology were more frequent in obese patients and sufficiently so as to discriminate between groups. Of obese patients, 47.2% were reclassified as HUD patients. The severity of the Worthlessness-Being Trapped dimension was sufficient to predict the BMI of obese individuals. Our results suggest that the five-factor psychopathology found in HUD can discriminate between HUD and obese patients, but that there is an area of overlap between the forms of psychopathology found in SUD and those found in obese patients.

摘要

引言 在本研究中,我们使用了一份症状清单(SCL - 90)来证实物质使用障碍(SUD)具有其自身的五维精神病理学这一假设。本研究的目的是检验这种精神病理学是否能够与其他精神科精神病理维度(如肥胖症)区分开来。通过比较972名海洛因使用障碍(HUD)患者(83.5%为男性,平均年龄30.12±6.6岁,范围:16 - 59岁)和106名肥胖个体(50.0%为男性,平均年龄37.59±7.6岁,范围:24 - 52岁),在单变量和多变量水平上研究了五个维度中每个维度的严重程度和频率。还研究了肥胖个体的体重指数(BMI)与这些精神病理维度之间的相关性。肥胖个体的SCL - 90总分、总体严重程度指数得分、阳性评定项目数和阳性症状痛苦指数得分均高于HUD患者。肥胖个体所有精神病理维度的严重程度均显著更高。判别分析表明,惊恐 - 焦虑和暴力 - 自杀严重程度在肥胖患者中更为常见,足以区分HUD(严重程度较低)和肥胖个体(严重程度较高)。在重新分类水平上,样本中70.8%的肥胖个体被重新分类为HUD患者。以惊恐 - 焦虑和暴力 - 自杀类型为特征的精神病理亚型在肥胖患者中更为常见,足以区分不同组。在肥胖患者中,47.2%被重新分类为HUD患者。无价值感 - 被困维度的严重程度足以预测肥胖个体的BMI。我们的结果表明,在HUD中发现的五因素精神病理学可以区分HUD和肥胖患者,但在SUD中发现的精神病理形式与肥胖患者中发现的精神病理形式之间存在重叠区域。

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