Blatt S J, Rounsaville B, Eyre S L, Wilber C
J Nerv Ment Dis. 1984 Jun;172(6):342-52. doi: 10.1097/00005053-198406000-00005.
Opiate addicts and polydrug, but nonopiate, substance abusers were assessed for depression on the Raskin rating scale for a clinical interview and several self-report measures of depression including the Hamilton, SCL-90, and the recently developed Depressive Experiences Questionnaire (DEQ), which differentially assesses depression focused around neediness from a depression focused around self-criticism (guilt and shame). Opiate addicts were consistently more depressed than polydrug drug abusers on all the measures. On the DEQ, opiate addicts were significantly (p less than .001) more depressed than normals and even somewhat more depressed than psychiatric patients. This depression, however, was focused primarily around issues of self-criticism, guilt, and shame rather than issues of dependency, abandonment, rejection, and neglect. Even further, depression focused around self-criticism, as measured on the DEQ, was significantly correlated (p less than .001) with the extent to which the polydrug, non-opiate-addicted substance abusers had begun to experiment with opiates. These data suggest that intense depression, particularly depression focused around issues of self-criticism, has an important role in opiate addiction.
使用临床访谈中的拉斯金评定量表以及包括汉密尔顿量表、症状自评量表90（SCL - 90）和最近开发的抑郁体验问卷（DEQ）在内的几种抑郁自评量表，对阿片类药物成瘾者和多种药物（但非阿片类）滥用者进行抑郁评估。抑郁体验问卷能分别评估围绕需求感的抑郁和围绕自我批评（内疚和羞耻）的抑郁。在所有测量指标上，阿片类药物成瘾者始终比多种药物滥用者更抑郁。在抑郁体验问卷上，阿片类药物成瘾者比正常人明显更抑郁（p小于0.001），甚至比精神科患者还要稍抑郁一些。然而，这种抑郁主要集中在自我批评、内疚和羞耻问题上，而非依赖、被抛弃、被拒绝和被忽视问题上。更进一步的是，根据抑郁体验问卷测量，围绕自我批评的抑郁与多种药物滥用（非阿片类成瘾）者开始尝试使用阿片类药物的程度显著相关（p小于0.001）。这些数据表明，强烈的抑郁，尤其是围绕自我批评问题的抑郁，在阿片类药物成瘾中起着重要作用。
