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Compr Psychiatry. 2014 Jul;55(5):1244-51. doi: 10.1016/j.comppsych.2014.03.012. Epub 2014 Mar 26.

Towards a unitary perspective between post-traumatic stress disorder and substance use disorder. Heroin use disorder as case study.

Author information

1
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy, EU.
2
Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Italy, EU.
3
Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Italy, EU; Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy, EU.
4
Social and Health Services, Health District 8 (ASL 8) Cagliari, Italy, EU.
5
Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Italy, EU; Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy, EU; G. De Lisio Institute of Behavioral Sciences, Pisa, Italy, EU. Electronic address: maremman@med.unipi.it.

Abstract

BACKGROUND:

Genetic, neurobiological, environmental and psychosocial mechanisms have received considerable attention in exploring the mechanisms that underlie comorbid PTSD and SUD. PTSD and SUD are not necessarily linked by a causal relationship, as the self-medication hypothesis had supposed. They might, in fact, both be caused by a third factor that predisposes these subjects to develop the two disorders (so allowing a unitary perspective).

METHODS:

Using a conceptualization of the PTSD spectrum, we studied the PTSD-SUD unitary perspective by testing the correlation between severity of heroin addiction, dose of opioid medication and severity of PTSD spectrum in 82 methadone-treated, heroin-dependent patients.

RESULTS:

Canonical correlation analysis (Wilks Lambda=0.125F=1.41 p=0.014), univariate and multivariate comparisons between subgroups, identified on the basis of addiction severity, showed a highly positive correlation between the PTSD spectrum and the severity of heroin addiction. In addition, negative correlations were found between PTSD spectrum severity and methadone dose (r=0.225; p=0.042).

CONCLUSIONS:

This strength and breadth of the correlations encourage us to move towards a unified vision of the two disorders.

PMID:
24791684
DOI:
10.1016/j.comppsych.2014.03.012
[Indexed for MEDLINE]

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