Ethnicity and specific psychopathology of addiction. Comparison between Slovenian and Italian Heroin Use Disorder patients

Background: In Heroin Use Disorder (HUD) patients, by applying a PCA factor analysis to the 90 items listed in the SCL90 checklist, 5-factor psychopathology was identified for the first time and was then confirmed in other Substance Use Disorders. The first factor reflected a depressive 'Worthlessness-Being Trapped' dimension (W/BT); the second factor picked out a ‘Somatic Symptoms' dimension (SS); the third identified a 'Sensitivity-Psychoticism' dimension (S/P); the fourth a 'Panic Anxiety' dimension (PA); and the fifth a 'Violence-Suicide' dimension (V/S). We confirmed the dimensions' specificity, testing their independence from state-addiction conditions such as treatment typology, type of drug involved, concomitant psychiatric problems, active substance use, and stress reactivity. Methods: In this study, 66 Slovenian HUD (SLO-HUD) patients requesting Agonist Opioid Treatment (AOT) were matched with 66 Italian ones (IT-HUD) according to age and gender; the severity and typology of the five SCL90 dimensions were then compared between the two groups, at the univariate and multivariate levels. Results: Severity of psychopathology was able to differentiate SLO-HUD from IT-HUD patients. At univariate level, the S/P PA and V/S dimensions were more severe in SLO-HUD patients, whereas multivariate discriminant analysis was only able to poorly differentiate SLO-HUD from IT-HUD patients (Wilks' Lambda=0.90; 2=12.73; df=5; p<0.026), showing that only 62.9% of the cases, as initially grouped, had been correctly classified. At the other extreme, psychopathological typology was unable to differentiate between the two samples, SLO-HUD and IT-HUD (2=2.14; p=0.709). Conclusions: This study, by demonstrating the same psychopathological typology in SLO-HUD and IT-HUD patients, further supports the specificity of the proposed factorial dimensions that go to make up the psychopathology of SUD.