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Subjective reports of withdrawl among cocaine users : recommendations for DSM-IV
(Informations Subjectives sur le sevrage chez les cocaïnomanes : recommandations pour le DSM-IV)
Auteur(s) :
L. B. COTTLER ;
A. M. SHILLINGTON ;
W. M. III COMPTON ;
D. MAGER ;
E. L. SPITZNAGEL
Refs biblio. :
15
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Anglais
Note générale :
Drug and Alcohol Dependence , 1993, 33, 97-104
Résumé :
FRANÇAIS :
Afin de compléter la liste préexistante des symptômes de sevrage proposés dans les systèmes de diagnostic (DSM III et DSM IV), les auteurs ont étudiés ceux qui se rapportent spécifiquement aux usagers de cocaïne et proposent d'en inclure certains dans le DSM-IV, pour faciliter la mise en place des traitements.
ENGLISH :
The proposed DSM-IV criteria for substance use disorders have included, as an option, a subtyping for physiologic dependence, characterized by either tolerance or withdrawal. Wider surveillance of withdrawal is possible with the CIDI Substance Abuse Module (SAM), we used the SAM, which includes a master list of all symptoms (n=16) in the DSM manuals related to withdrawal from any substance to assess withdrawal symptoms from all substances. In this study, we compared the responses of persons who used cocaine and opiates (opiate users) with the responses of persons who used cocaine without opiates (non-opiate users). The symptoms mentioned in the diagnostic manuals were among the most frequently endorsed by both cocaine use groups. However, other symptoms not included in the manual were reported with equal or higher frequency to those in the manual regardless of opiate use. 'Feeling anxious or irritable' and 'having trouble concentrating' were symptoms endorsed by about 40 % and 35 % of the sample, respectively. No significant difference between the opiate and non-opiate group was found to be frequently attributed to withdrawal from any other substance. Controlling for the effects of age, gender, onset of cocaine use and opiate use, we found that these two symptoms were predicted by an earlier age of onset of cocaine use. Although more epidemiologic and clinical work along these lines are needed in this area, our recommendation is that these two symptoms be considered for DSM-IV Cocaine Withdrawal Syndrome. the
Afin de compléter la liste préexistante des symptômes de sevrage proposés dans les systèmes de diagnostic (DSM III et DSM IV), les auteurs ont étudiés ceux qui se rapportent spécifiquement aux usagers de cocaïne et proposent d'en inclure certains dans le DSM-IV, pour faciliter la mise en place des traitements.
ENGLISH :
The proposed DSM-IV criteria for substance use disorders have included, as an option, a subtyping for physiologic dependence, characterized by either tolerance or withdrawal. Wider surveillance of withdrawal is possible with the CIDI Substance Abuse Module (SAM), we used the SAM, which includes a master list of all symptoms (n=16) in the DSM manuals related to withdrawal from any substance to assess withdrawal symptoms from all substances. In this study, we compared the responses of persons who used cocaine and opiates (opiate users) with the responses of persons who used cocaine without opiates (non-opiate users). The symptoms mentioned in the diagnostic manuals were among the most frequently endorsed by both cocaine use groups. However, other symptoms not included in the manual were reported with equal or higher frequency to those in the manual regardless of opiate use. 'Feeling anxious or irritable' and 'having trouble concentrating' were symptoms endorsed by about 40 % and 35 % of the sample, respectively. No significant difference between the opiate and non-opiate group was found to be frequently attributed to withdrawal from any other substance. Controlling for the effects of age, gender, onset of cocaine use and opiate use, we found that these two symptoms were predicted by an earlier age of onset of cocaine use. Although more epidemiologic and clinical work along these lines are needed in this area, our recommendation is that these two symptoms be considered for DSM-IV Cocaine Withdrawal Syndrome. the
Affiliation :
Dept Psychiatr. , Washington Univ. Sch. Med. 4940 Children's Place, St. Louis MO 63110
Etats-Unis. United States.
Etats-Unis. United States.
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