Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous study on methadone-treated heroin use disorder (HUD) patients, we demonstrated strong correlations between the severity and progression of HUD and the subsequently greater severity of PTSD spectrum symptoms, so suggesting a unitary perspective. Methods. A comparative cross-sectional study was carried out to evaluate post-traumatic spectrum reactivity to loss and traumatic events in three groups: acute catastrophic event survivors experiencing (N=77) and the same number not experiencing PTSD (N=77), and a third group, of long-lasting HUD subjects who had never been exposed to catastrophic events (N=77). Results. To obtain an index of the magnitude of emotional response to losses and traumatic events, we conducted a preliminary ROC analysis on the TALS-SR total scores observed in our L’Aquila 2009 earthquake database, after having classified subjects as PTSD and No-PTSD (according to the SCID-questionnaire). That analysis determined the cut-off value required to ensure the best balance between sensitivity and specificity. The percentage of subjects who were over the threshold in the HUD group proved to be very similar to that observed in the PTSD earthquake survivors group [51 (66.2%) vs 56 (72.7%), Chi-square=0.49, p=.484], whereas it turned out to be significantly higher than that observed in the No-PTSD earthquake survivors group [51 (66.2%) vs 11 (14.3%), Chisquare= 41.07, p<.001]. Furthermore, the discriminant analysis utilizing TALS-SR domain scores as predictive variables failed to discriminate between the HUD group and the PTSD earthquake group, whereas it appears to clearly differentiate the No-PTSD earthquake group from the other two. Conclusions. This study, besides providing evidence of similarities in the type of reaction shown to loss and to traumatic events between HUD patients and earthquake survivors with PTSD, also supports the probable implication of the opioid system in the aetio(patho)logy of PTSD.

Life events (Loss and traumatic) and emotional responses to them in acute catastrophe survivors and long-lasting heroin use disorder patients never exposed to catastrophic events

DELL'OSSO, LILIANA;MASSIMETTI, ENRICO;CARMASSI, CLAUDIA;STRATTA, PAOLO;MASSIMETTI, GABRIELE;MAREMMANI, ICRO
2015

Abstract

Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous study on methadone-treated heroin use disorder (HUD) patients, we demonstrated strong correlations between the severity and progression of HUD and the subsequently greater severity of PTSD spectrum symptoms, so suggesting a unitary perspective. Methods. A comparative cross-sectional study was carried out to evaluate post-traumatic spectrum reactivity to loss and traumatic events in three groups: acute catastrophic event survivors experiencing (N=77) and the same number not experiencing PTSD (N=77), and a third group, of long-lasting HUD subjects who had never been exposed to catastrophic events (N=77). Results. To obtain an index of the magnitude of emotional response to losses and traumatic events, we conducted a preliminary ROC analysis on the TALS-SR total scores observed in our L’Aquila 2009 earthquake database, after having classified subjects as PTSD and No-PTSD (according to the SCID-questionnaire). That analysis determined the cut-off value required to ensure the best balance between sensitivity and specificity. The percentage of subjects who were over the threshold in the HUD group proved to be very similar to that observed in the PTSD earthquake survivors group [51 (66.2%) vs 56 (72.7%), Chi-square=0.49, p=.484], whereas it turned out to be significantly higher than that observed in the No-PTSD earthquake survivors group [51 (66.2%) vs 11 (14.3%), Chisquare= 41.07, p<.001]. Furthermore, the discriminant analysis utilizing TALS-SR domain scores as predictive variables failed to discriminate between the HUD group and the PTSD earthquake group, whereas it appears to clearly differentiate the No-PTSD earthquake group from the other two. Conclusions. This study, besides providing evidence of similarities in the type of reaction shown to loss and to traumatic events between HUD patients and earthquake survivors with PTSD, also supports the probable implication of the opioid system in the aetio(patho)logy of PTSD.
Dell'Osso, Liliana; Massimetti, Enrico; Rugani, Fabio; Carmassi, Claudia; Fareed, Ayman; Stratta, Paolo; Rossi, Alessandro; Massimetti, Gabriele; Maremmani, Icro
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11568/759979
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