Primary research

The mental status of 1090 heroin addicts at entry into treatment: should depression be considered a 'dual diagnosis'?

Icro Maremmani^1,2,3 , Matteo Pacini^1,2 , Pier Paolo Pani⁴ , Giulio Perugi^1,2 , Joseph Deltito⁵ and Hagop Akiskal⁶

¹Vincent P. Dole Dual Diagnosis Group, 'Santa Chiara' University Hospital, Department of Psychiatry PNB, University of Pisa, Italy

²G. De Lisio Institute of Behavioral Sciences, Pisa, Italy

³AU-CNS, 'From Science to Public Policy' Association, Pietrasanta, Lucca, Italy

⁴Social-Health Integration Service, Office of Social Policies, Sardinia Health and Social Administration, Sardinia Autonomous Region, Cagliari, Italy

⁵Department of Psychiatry and Behavioral Science, New York Medical College, Valhalla, New York, USA

⁶International Mood Center, University of California at San Diego, La Jolla, and Veterans Administration Medical Center, San Diego, California, USA

author email corresponding author email

Annals of General Psychiatry 2007, 6:31doi:10.1186/1744-859X-6-31

Published:	13 November 2007

Abstract

Background

Mental symptoms are common in heroin addiction and may arise from issues of addiction and withdrawal, raising doubts about the patients truly having co-morbid psychiatric diagnoses.

Methods

We studied the mental status of 1090 heroin addicts (831 males and 259 females aged between 16 and 51 years) at the beginning of treatment, and its relationship to relevant demographic and clinical data through the use of standardised instruments.

Results

A total of 506 (46.42%) heroin addicts showed depressive-anxious symptomatology, 421 (38.62%) had psychomotor excitement and 163 (14.95%) demonstrated a psychotic state. Patients with depressive-anxious symptomatology on the whole had a less severe addictive illness compared to those demonstrating excited and psychotic symptoms. The presence of depressive-anxious features was felt to not necessarily be indicative of the presence of a dual diagnosis.

Conclusion

The presence of depressive-anxious symptomatology in the clinical presentation in heroin addicts appears to be unrelated to 'dual diagnosis'.