Relationship between psychopathological symptoms and drug addiction, and mediating role of psychological distress in drug addicts

doi:10.3969/j.issn.1674-8115.2025.01.006

Abstract

Abstract:

Objective ·To identify different comorbidity types resulting from the spontaneous association of psychopathological symptoms among male drug addicts, explore the relationship between latent types and drug addiction, and examine the mediating role of psychological distress. Methods ·Four hundred and fifty male drug addicts, recruited by Yunnan First Compulsory Isolation Drug Rehabilitation Center according to the 2017 revised Drug Addiction Identification Method by the Ministry of Public Security, were enrolled as participants. The Symptom Checklist-90 (SCL-90), Craving Automated Scale for Substances (CAS-S), and Psychache Scale (PAS) were used to assess the severity of psychopathological symptoms, drug addiction, and psychological distress, respectively. Latent class analysis was employed to identify different types of psychopathological comorbidity that may exist in the participants, and the types were named based on the analysis results. Variance analysis was used to test differences in the severity of drug addiction and psychological distress among different latent types, and a mediation model was established to explore the mediating role of psychological distress between different latent types and drug addiction. Results ·Latent class analysis identified three types of psychopathology: high, medium, and low levels, with decreasing positive rates and numbers of comorbidity in each type based on the ten psychopathological symptoms included in the SCL-90. There were significant differences in the severity of psychological distress and drug addiction among the three types of participants. Psychopathological symptoms positively predicted the severity of psychological distress and drug addiction. Psychological distress completely mediated the relationship between medium levels of psychopathology and drug addiction, while partially mediating the relationship between high levels of psychopathology and drug addiction. Conclusion ·There are three types of psychopathological comorbidity among male drug addicts: high, medium, and low. Psychological distress plays a complete mediating role between medium levels of psychopathology and drug addiction, and a partial mediating role between high levels of psychopathology and drug addiction.

Key words: drug addiction, psychopathological symptoms, psychological distress, comorbidity, latent class analysis

CLC Number:

R749

GAO Yuyan, LI Wei, WANG Shuting, KISHIMOTO Tomoko, ZHANG Ruyuan. Relationship between psychopathological symptoms and drug addiction, and mediating role of psychological distress in drug addicts[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(1): 51-59.

Figures/Tables 7

TrendMD

References 38

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Item	Full sample (n=402)	High SCL (n=21)	Middle SCL (n=74)	Low SCL (n=307)
Psychoticism	40 (9.95)	9 (42.86)	27 (36.49)	4 (1.30)
Paranoid ideation	49 (12.19)	18 (85.71)	31 (41.89)	0 (0)
Phobic-anxiety	40 (9.95)	14 (66.67)	26 (35.14)	0 (0)
Anger-hostility	61 (15.17)	18 (85.71)	38 (51.35)	5 (1.62)
Anxiety	38 (9.45)	17 (80.95)	20 (27.02)	1 (0.33)
Depression	41 (10.20)	17 (80.95)	24 (32.43)	0 (0)
Interpersonal sensitivity	47 (11.69)	18 (85.71)	26 (35.14)	3 (0.97)
Obsessive-compulsive	49 (12.19)	19 (90.48)	24 (32.43)	6 (1.95)
Somatization	40 (9.95)	20 (95.24)	17 (22.97)	3 (0.97)
Additional items	52 (12.94)	18 (85.71)	30 (40.54)	4 (1.30)
Number of symptoms
0	281 (69.90)	0 (0)	0 (0)	281 (91.53)
1	28 (6.70)	0 (0)	2 (2.70)	26 (8.47)
2	20 (4.98)	0 (0)	20 (27.03)	0 (0)
3	18 (4.48)	0 (0)	18 (24.32)	0 (0)
Item	Full sample (n=402)	High SCL (n=21)	Middle SCL (n=74)	Low SCL (n=307)
4	12 (2.99)	0 (0)	12 (16.22)	0 (0)
5	14 (3.48)	0 (0)	14 (18.92)	0 (0)
6	10 (2.49)	3 (14.29)	7 (9.45)	0 (0)
7	8 (1.99)	7 (33.33)	1 (1.35)	0 (0)
8	1 (0.25)	1 (4.76)	0 (0)	0 (0)
9	7 (1.74)	7 (33.33)	0 (0)	0 (0)
10	3 (0.75)	3 (14.29)	0 (0)	0 (0)

Item	Full sample (n=402)	High SCL (n=21)	Middle SCL (n=74)	Low SCL (n=307)
Psychoticism	40 (9.95)	9 (42.86)	27 (36.49)	4 (1.30)
Paranoid ideation	49 (12.19)	18 (85.71)	31 (41.89)	0 (0)
Phobic-anxiety	40 (9.95)	14 (66.67)	26 (35.14)	0 (0)
Anger-hostility	61 (15.17)	18 (85.71)	38 (51.35)	5 (1.62)
Anxiety	38 (9.45)	17 (80.95)	20 (27.02)	1 (0.33)
Depression	41 (10.20)	17 (80.95)	24 (32.43)	0 (0)
Interpersonal sensitivity	47 (11.69)	18 (85.71)	26 (35.14)	3 (0.97)
Obsessive-compulsive	49 (12.19)	19 (90.48)	24 (32.43)	6 (1.95)
Somatization	40 (9.95)	20 (95.24)	17 (22.97)	3 (0.97)
Additional items	52 (12.94)	18 (85.71)	30 (40.54)	4 (1.30)
Number of symptoms
0	281 (69.90)	0 (0)	0 (0)	281 (91.53)
1	28 (6.70)	0 (0)	2 (2.70)	26 (8.47)
2	20 (4.98)	0 (0)	20 (27.03)	0 (0)
3	18 (4.48)	0 (0)	18 (24.32)	0 (0)
Item	Full sample (n=402)	High SCL (n=21)	Middle SCL (n=74)	Low SCL (n=307)
4	12 (2.99)	0 (0)	12 (16.22)	0 (0)
5	14 (3.48)	0 (0)	14 (18.92)	0 (0)
6	10 (2.49)	3 (14.29)	7 (9.45)	0 (0)
7	8 (1.99)	7 (33.33)	1 (1.35)	0 (0)
8	1 (0.25)	1 (4.76)	0 (0)	0 (0)
9	7 (1.74)	7 (33.33)	0 (0)	0 (0)
10	3 (0.75)	3 (14.29)	0 (0)	0 (0)

Category	Log likelihood	AIC	BIC	ssaBIC	Entropy	LMRT(P)	BLRT(P)
1	-1 419.600	2 858.319	2 898.308	2 866.577
2	-998.399	2 038.799	2 122.777	2 056.141	0.953	0.000	0.000
3	-963.266	1 990.532	2 118.498	2 016.958	0.924	0.153	0.000
4	-926.591	1 982.996	2 154.951	2 018.507	0.932	0.245	0.065

Category	Log likelihood	AIC	BIC	ssaBIC	Entropy	LMRT(P)	BLRT(P)
1	-1 419.600	2 858.319	2 898.308	2 866.577
2	-998.399	2 038.799	2 122.777	2 056.141	0.953	0.000	0.000
3	-963.266	1 990.532	2 118.498	2 016.958	0.924	0.153	0.000
4	-926.591	1 982.996	2 154.951	2 018.507	0.932	0.245	0.065

Item	High SCL (n=21)	Middle SCL (n=74)	Low SCL (n=307)	P value	Pairwise comparisons
Age/year	44.154±3.053	40.227±2.912	37.384±3.143	0.001	C1>C3
Education/n				0.212
Junior middle school and below	21.000±10.002	63.000±9.224	246.000±8.951
High school		9.000±3.492	51.000±4.075
Junior college		1.000±1.176	5.000±1.264
Bachelor′s degree and above		1.000±1.182	5.000±1.306
Marital status/n				0.589
Married	9.000±6.556	42.000±7.543	128.000±6.464
Divorce	5.000±4.882	13.000±4.206	69.000±4.742
Unmarried	7.000±5.775	19.000±5.056	110.000±5.976
Age of first drug use/year	29.482±3.303	25.487±2.732	24.532±2.821	0.022	C1>C3
Years of drug use/year	14.624±3.121	14.743±2.864	12.846±2.943	0.181
Number of relapses/n	4.055±3.431	2.092±2.005	1.598±1.483	0.006	C1>C3, C2>C3
Number of symptoms/n	8.006±1.174	3.553±1.202	0.082±0.532	<0.001	C1>C2>C3
SCL-90/score	198.523±4.557	150.802±6.121	82.172±6.781	<0.001	C1>C2>C3
CAS/score	41.003±2.402	36.946±2.443	32.703±6.887	<0.001	C1>C2>C3
PAS/score	37.102±2.523	36.383±2.582	25.964±2.942	<0.001	C1>C3, C2>C3