Substance Abuse, Temperament and Suicide Risk: Evidence from a Case-Control Study

Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Journal of Addictive Diseases (Impact Factor: 1.46). 02/2009; 28(1):13-20. DOI: 10.1080/10550880802544757
Source: PubMed


The aim of the current study was to evaluate differences between two matched groups of psychiatric outpatients (those with and those without substance abuse) on clinical variables that previous research has suggested may be associated with substance abuse comorbidity. The sample consisted of 31 consecutively admitted psychiatric outpatients (16 men and 15 women) with substance use comorbidity; controls were 31 outpatients without substance use comorbidity who were matched for sex and age. The patients completed the Mini International Neuropsychiatric Interview, the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version, the Symptom Checklist-90-Revised, the Gotland Male Depression Scale, and the Beck Hopelessness Scale. As a group, the substance abusers had a different temperament profile (higher dysthymic/cyclothymic/anxiety and irritability and lower hyperthymic traits), a higher hopelessness, global psychopathology severity, impulsivity/aggression, and suicide risk (higher lifetime suicide ideation and suicide attempts), and were more frequently depressed. However, few differences were significant and almost all were of small magnitude. Furthermore, bipolar disorders type II were overrepresented in the abuser group compared to the control group (45% vs. 22%, respectively).

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    • "Most studies show that comorbidity prevalence ranges between 55% and 85% (Torrens et al., 2011; Arias et al., 2013). The most prevalent disorders of DSM- IV-TR Axis I are psychotic, depressive and anxiety disorders (Lukasiewicz et al., 2009; Vergara-Moragues et al., 2012), whereas for Axis II are antisocial, borderline, narcissistic and histrionic personality disorders of cluster B (Modestin et al., 2007; Ringen et al., 2008; Pompili et al., 2009). DD is most common in males who are usually psychotic and bipolar, whereas for dual women the most typical diseases are depression and anxiety (Rush and Koegl, 2008; Miquel et al., 2011). "
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    ABSTRACT: Dual diagnosis (DD) is the coexistence of a substance use disorder (SUD) and severe mental illness (SMI). The aim of this study is to determine for the first time if a specific personality pattern exists for DD patients compared to those who only have SUD or SMI. The sample was composed of 102 male, 34 patients in each group (DD, SUD and SMI). DD and SMI groups included 20 schizophrenic and 14 depressed patients respectively. Cloninger׳s TCI-R was administered together with a structured interview of sociodemographic and clinical characteristics. All the temperament dimensions and Self-directedness provided differences among groups. The DD and SUD showed significant higher scores in Novelty Seeking regarding SMI, whereas for Harm Avoidance the SUD subjects scored lower with respect to the DD and SMI group. Persistence was significant lower for the DD and SMI groups compared to the SUD patients. The DD obtained low significant scores in Reward Dependence in relation to the SUD and Self-directedness in relation to the SUD and SMI. Our data highlight the presence of a different personality profiles among DD, SUD and SMI disorders. Taking into account the patients׳ personality can benefit the clinical course and minimize the DD impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 06/2015; DOI:10.1016/j.psychres.2015.05.059 · 2.47 Impact Factor
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    • "Male depression was found to be equally severe in men and women who had made a nonviolent suicide attempt [24]. Both men and women with substance abuse have a higher probability of having male depression and higher suicide risk than those without substance abuse [25]. "
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    ABSTRACT: Objectives and Methods. This was an observational study of the efficacy of short-term psychodynamic psychotherapy (STPP) in a sample of 35 (30 women and 5 men) patients with moderate-to-severe "male depression" (Gotland Scale for Male Depression (GSMD) ≥ 13) comorbid with unipolar mood disorder (dysthymia and major depression) or anxiety disorder. Outcome measures were GSMD and BHS (Beck Hopelessness Scale) score changes from baseline. Results. Patients had a strong response to STPP on the GSMD (estimated mean score change (± SE) = -9.08 ± 2.74; P < 0.01; partial eta squared = 0.50), but not on the BHS (estimated mean score change (± SE) = -0.92 ± 1.55; P = 0.57; partial eta squared = 0.03). BHS score changes were significantly associated with GSMD score changes (Pearson's r = 0.56; P < 0.001), even when controlling for the severity of hopelessness at the baseline (partial r = 0.62; P < 0.001). Conclusions. STPP proved to be effective in patients suffering from "male depression" although hopelessness was only marginally reduced by this treatment which points to the need to better understand how STPP can be involved in the reduction of suicide risk.
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