Peculiarities of Temperament and Character of Patients with Comorbid Psychiatric Pathology and Combined Dependence on Psychostimulants and Other Psychoactive Substances

Abstract

INTRODUCTION: According to official statistics, there is an annual increase in the production and consumption of various psychostimulants, and as a result, an increase in the number of patients with addiction of psychostimulants. At the same time, there are no effective methods of treating such disorders within the framework of a modern personalized approach to therapy. AIM: To study peculiarities of the temperament and character of patients with combined dependence on psychostimulants and other psychoactive substances (PASs) and with comorbid psychiatric pathology to increase the effectiveness of psychotherapeutic methods in personalized therapeutic approach. MATERIALS AND METHODS: The study included 325 patients (ethnic Russian men and women aged from 18 to 50 years) with the diagnosis: dependence on psychostimulants and dependence on psychostimulants in combination with comorbid psychiatric pathology, who signed the informed consent. R. Cloninger method of assessment of the temperament and character (Temperament and Character Inventory, TCI-125) was used. RESULTS: Patients were divided to groups depending on PASs used by them and the existence of comorbid psychiatric pathology. Of temperament dimensions, the novelty seeking predominated in all the groups (up to 15 points; р 0.002) in comparison with harm avoidance (up to 10 points; р 0.112), reward dependence (up to 9 points; р 0.442) and persistence (up to 3 points; р 0.226). This combination of temperament dimensions corresponds to antisocial personality disorder. High cooperativeness (17 points; p 0.005) was observed in patients with a full course of rehabilitation and remissions up to 12 months. The maximal self-transcendence (10 points; p 0.02) corresponded to psychiatric pathology. CONCLUSION: On the basis of the results obtained, personality profiles of patients were determined. Patients of the first profile with dependence only on psychostimulants with minimal novelty seeking dimension of the temperament along with high cooperativeness character trait were more communicative, adapted to the treatment and rehabilitation program, and had longer remission periods. Patients of the second profile with a combined dependence on psychostimulants and other PASs with maximal novelty seeking dimension in the temperament along with minimal values on the character scales required the maximal effort of the specialists to keep them in the treatment and rehabilitation program. Patients of the third profile with dependence on psychostimulants and comorbid psychiatric pathology with maximal novelty seeking dimension in the temperament together with maximal self-transcendence were characterized by suspiciousness and required a special gradual establishment of psychotherapeutic contact to involve them in the treatment and rehabilitation process.